Caption

A nurse applies a fresh dressing to the gangrenous toes of a 96-year-old woman with diabetes mellitus. Gangrene (localised tissue death, black) has resulted from ulcers on the big toe and second toe. An ulcer is an open sore that does not heal and may turn necrotic, as seen here. Diabetes can lead to neuropathy (nerve damage) and peripheral vascular disease, both risk factors for the development of ulcers and gangrene in the extremities. In severe cases amputation may be required.