Case Reports

In late summer we have noticed inc:reued refertals to our Diabetic Foot Clinic for neuropathic ulcers origlnatina on foreign holidays. Five of these patients with 6 ulcers stemmina from 6 holidays are reported. All patients were male Type 2 diabetics, mean age 57 years, and mea duration of disease 10 years. The ulcers were caused by trauma fiom walking bare-foot (3). wearina 'flip-tlops' (2) and direct thermal trauma &om bot Jllvina stones (I). Sites of ulc:eration were tbe dorsal metatanal bead ( 1 ), tbe plantar metatarsal heads (3). the midfoot sole (1) and toe tip (I). Countries of origin were mainland Spain (3). Majorca (1). Mexico (1) and Crete (1). Pressure relief, debridement and antibiotics u outpatients proved ~UCCC~~ful in 2 patients, thouab 3 required a total of 4 admissions to hospital with a mean stay of 17 days. Two patients had had previous IICIII'OpGhic foot ulcers with intensive footcare education. These messages appear to be forgotten on holiday. Al10 UIIICCustomed exercise. potentially hazardous environments and possibly poorer diabe_ric control may contribute to this problem. We suaaest specific wanunp sbould be given to diabetic pUients aoina 011 forelp 'beech holidays'. and especially to thole with at·rilk feet.