Crystal Thermography (LCT) and a body weighing scale with builtin
thermistors [14,40].
Texture of the skin, which is an important indicator of the
general health of diabetic patients, is another factor that should be
evaluated carefully. Totally, skin hardiness is considered as a risk
factor for neuropathic DFU and should be examined seriously
[35]. Studies have demonstrated an increased glycation of keratin
from the stratum corneum of the skin of diabetic feet that can
account for the increase of skin hardiness in these patients
[41]. Recent studies recommended durometry as a new and easy
method to assess skin hardness in diabetic patients [41,42]. This
instrument shows the relative degree of skin hardness on a linear
calibrated gauge as the result of a spring-loaded interior that
senses hardness by applying an indentation load on the specimen
(Fig. 6) [41]. Determination of skin hardness by this instrument has
been proven to be accurate and reproducible in diabetic patients
who are at risk for neuropathic DFU [41,42].