A sharply defined, deep cut out, non-healing ( no granulation tissue visible in the base) ulcer, symmetrically located on the pressure points of both feet, suggests that this is a 'neurogenic aka trophic ulcer'. The mechanism of such a ulcer is repeated injury or pressure in an area which has lost the appreciation of pain. The neurological conditions which predispose to formation of such an ulcer includes - 1) Diabetes mellitus ( most common ) 2) Alcoholic peripheral neuritis 3) Tabes Dorsalis 4) Spina Bifida 5) Leprosy 6) peripheral nerve injury 7) Paraplegia 8) Syringomyelia - - - - (-:
