It seems to be a case of diabetic foot
which is one of the commonest complication of uncontrolled diabetes
.The cause is multifactorial like neuropathic as well as angiopathic.
Neuropathy leads to sensory dysfunction leading to painless ulcer and autonomic dysfunction leads to drying of skin.
Angiopathy leads to ischaemia and infection leading to delayed wound healing
Diabetic peripheral neuropathy
leads to impaired sensations in lower limbs making the foot vulnerable to trauma.
A non healing foot ulcer may lead to osteomyelitis
of tarsal and metatarsal bones.
She must be immediately hospitalised and evaluated properly by doing pus culture and MRI foot to look for osteomyelitis.
She may require surgical debridement along with proper antibiotic therapy.
diabetic foot ulceration is considered the most likely predictor of eventual lower extremity amputation in patients with diabetes mellitus