Introduction: Diabetes is a frequent pathology that has universal distribution. The incidence of the type 2 of this condition has been increasing with obesity. Early detection of dermatological, vascular, orthopedic and neurological origin pathologies helps the diagnosis and treatment of the diabetic foot.
Objective: To evaluate the feet of pre-diabetic and diabetic patients bearers of onychomycosis using thermography, aiming at identifying the vascular, neurological and orthopedic impairment, as well as following up the clinical development.
Methods: Capture of infrared images at baseline and after cold stimulus test, using an infrared sensor in a controlled environment.
Results: This examination allowed the suspicion of peripheral neuropathy of fine fibers to be raised, as well as to verify areas of footwear pressure and to evaluate the progression of Charcot foot.
Conclusions: Infrared imaging associated with dermatological examination can be a propaedeutic tool for the early identification of vasomotor alterations in the soles, even in asymptomatic patients.

Keywords: Diabetic foot; Diabetes Mellitus; Thermography

Necrobiosis Lipoidica (NL) is a granulomatous dermatosis, mainly affecting people with diabetes due to collagen degeneration. Although there are different treatments, all have little response. Among the options, the Intense Pulsed Light (IPL) and the Laser Erbium-YAG enhance the production and remodeling of the collagen treating the atrophy, besides reducing the erythema by the coagulation of blood vessels. We report a case of a 24-year-old woman with type I Diabetes Mellitus who underwent NL treatment on her left forearm in seven sessions with the association of IPL and 2940 nm Erbium-YAG laser. We observed improvement in central atrophy and erythema.

Keywords: Necrobiosis lipoidica; Diabetes mellitus; Lasers; Laser therapy; Intense pulsed light therapy; Collagen

A woman with type I diabetes and Hashimoto’s disease presented necrobiosis lipoidica at 15 years of age. Cyclosporine 100 mg/day was prescribed; however, an abscess in the inguinal region led to treatment interruption. Then, she tried dimethyl fumarate at increasing doses up to 120 mg/day. The lack of results led to the discontinuation of the therapy. The third attempt was isotretinoin 40 mg/day for eight months, with wound healing. Recently, after a knee scar repair surgery, necrobiosis lipoidica lesions appeared at the suture site. The patient received isotretinoin 40 mg/day again, and the lesion regressed in three months.

Keywords: Necrobiosis Lipoidica; Diabetes Mellitus, Type 1; Bacterial Infections