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There are ca. 8 million persons with diabetes mellitus living in Germany. A late sequelae of diabetes is the diabetic foot syndrome (DFS), the prevalence of which is greatly increasing. It comprises all alterations of the foot as a result of diabetic polyneuropathy as well as microvascular and macrovascular (peripheral arterial occlusive disease, PAOD) alterations. Many of the ca. 250,000 newly diagnosed diabetic foot ulcers per year become chronic wounds. Despite intensive efforts for prevention, early diagnosis and adequate wound care, ca. 13,000 persons with diabetes undergo major limb amputation in Germany every year. With consistent treatment in interdisciplinary centers and by exhausting all possible methods of wound treatment, pressure relief as well as arterial revascularization, the major amputation rate in patients with diabetic foot problems can be reduced by 80%. With a suitable strategy of prevention, the recurrence rate of foot ulcers would be reduced.In Deutschland leben ca. 8 Mio. Menschen mit Diabetes mellitus. Eine Spätfolge dieser Erkrankung ist das diabetische Fußsyndrom (DFS), dessen Prävalenz stark ansteigt. Es umfasst alle Veränderungen am Fuß als Folge der diabetischen Polyneuropathie sowie mikro- und makroangiopathischer (periphere arterielle Verschlusskrankheit, PAVK) Veränderungen. Jährlich entstehen ca. 250.000 neue diabetische Fußulzera. Diese werden oft zu chronischen Wunden. Trotz intensiver Bemühungen um Prävention, frühzeitige Diagnostik und stadiengerechte Wundbehandlung werden in Deutschland jährlich ca. 13.000 Majoramputationen bei Diabetikern durchgeführt. Bei konsequenter Therapie des DFS in interdisziplinären Zentren mit Ausschöpfung aller Möglichkeiten der Wundbehandlung, der Druckentlastung sowie einer arteriellen Revaskularisation kann die Majoramputationsrate um bis zu 80 % gesenkt werden. Durch eine geeignete Präventionsstrategie wäre die große Gefahr der Rezidivulzera geringer.

Proteus syndrome is a rare condition that involves atypical growth of the bones, skin and head and a variety of other symptoms. Only a few authors have reported on the craniofacial manifestations so far. The authors present a case of a 7-year-old girl with Proteus syndrome in which the facial skeleton showed unilateral overgrowth. The analysis of the radiological evaluation revealed a bialveolar prognathism, a skeletal class III, a dolicocephalic growth pattern and a left convex face scoliosis. On the left side, the lesser wing of the sphenoid was elevated and the ethmoidal cell complex was hypertrophic. The left ramus and body of the mandible were enlarged. The asymmetric dental development with a precocious dental age on the affected side was the most striking feature on the panoramic view. Early diagnosis and therapy depend on clinical evaluation and imaging. Therefore, further evaluations on the craniofacial features of patients with Proteus syndrome are necessary in order to establish a list of characteristic symptoms.