Fungal infection in foot diabetic patients

Background:Diabetic patients are more susceptible to cutaneous fungal infections. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. The main objective of this study was to find the frequency of fungal infections among cutaneous lesions of diabetic patients and to investigate azole antifungal agent susceptibility of the isolates.Materials and Methods:In this study, type 1diabetes (n = 78) and type 2 diabetes (n = 44) comprised 47 cases (38.5%) with diabetic foot ulcers and 75 cases (61.5%) with skin and nail lesions were studied. Fungal infection was confirmed by direct examination and culture methods. Antifungal susceptibility testing by broth microdilution method was performed according to the CLSI M27-A and M38-A references.Results:Out of 122 diabetic patients, thirty (24.5%) were affected with fungal infections. Frequency of fungal infection was 19.1% in patients with diabetic foot ulcer and 28% of patients with skin and nail lesions. Candida albicans and Aspergillus flavus were the most common species isolated from thirty patients with fungal infection, respectively. Susceptibility testing carried out on 18 representative isolates (13 C. albicans, five C. glabrata) revealed that 12 isolates (10 C. albicans and two C. glabrata isolates) (66.6%) were resistant (minimum inhibitory concentration [MIC] ≥64 mg/ml) to fluconazole (FCZ). Likewise, eight isolates (80%) of Aspergillus spp. were resistant (MIC ≥4 mg/ml), to itraconazole.Conclusion:Our finding expands current knowledge about the frequency of fungal infections in diabetic patients. We noted the high prevalence of FCZ-resistant Candida spp., particularly in diabetic foot ulcers. More attention is important in diabetic centers about this neglected issue.

Diabetic foot ulcers and blood glucose control are critical aspects of managing Diabetes Mellitus. This study aimed to analyze the relationship between the level of compliance with blood glucose control and the risk of diabetic foot ulcers in patients with Type II Diabetes Mellitus. A quantitative method with a cross-sectional design was employed. A total of 120 subjekts were selected proportionally from a population of 280 individuals in the working area of Bangkala Health Center, Makassar City, based on inclusion and exclusion criteria. A purposive sampling technique was used, and data were collected through a structured questionnaire. The data were analyzed using thechi-square test. The results showed that out of 66 subjekts who were compliant with blood glucose control, 52 were not at risk of developing diabetic foot ulcers, while 14 were at risk. Conversely, among the 54 non-compliant subjekts, 36 were at risk of developing diabetic ulcers, while 11 were not. Bivariate analysis revealed a p-value of 0.000,indicating a statistically significant relationship between the level of compliance with blood glucose control and the risk of diabetic foot ulcers. These findings support the hypothesis that effective blood glucose control significantly reduces the risk of diabetic foot ulcers in patients with Type II Diabetes Mellitus.

Background: Diabetic foot ulcers are one of the chronic complications of diabetes mellitus (DM) in the form of wounds on the skin surface of the feet of DM patients accompanied by internal tissue damage or tissue death, either with or without infection, which is associated with the presence of neuropathy and or peripheral arterial disease in patients with DM. The World Health Organization (WHO) states that at least 422 million people suffer from DM A new alternative parameter for assessing the degree of peripheral ischemia is ankle peak systolic velocity (PSV). The rationale for PSV is based on the observation that in the ischemic limb, blood travels at a much slower rate in the distal leg arteries than in the nonischemic limb. PSV is a quick and easy test to assess the patient's vascular status and monitor the development of diabetic foot ulcers, and can assess the degree of ischemia and predict healing of diabetic foot ulcers. This study aims to determine the Correlation of Peak Systolic Velocity Value with Wagner Score in Diabetic Foot Ulcer patients in RSUP Dr. M. Djamil Padang.
 Methods: This research is analytic observational with cross sectional design, the research uses primary data. This research will be conducted at the RSUP Dr. M. Djamil Padang from July 2021 to October 2021. The population in this study were diabetic foot ulcer patients who came for treatment at Dr. M. Djamil Padang. A sample of 32 patients Diabetic foot ulcer met the inclusion criteria. Univariate analysis was conducted to describe each of the variables studied. Numerical data is normally distributed, then it is presented in the form of mean ± standard deviation (SD), whereas if the numerical data is not normally distributed then it is presented in the form of median, minimum and maximum. Categorical data is presented in the form of frequency and percentage of each category. Bivariate analysis was started by using the data normality test using the Shapiro Wilk test (n<50). In testing the correlation between Peak Systolic Velocity and Wagner Score in diabetic foot ulcer patients, the Pearson correlation test is used if the data is normally distributed. Data analysis using SPSS version 22.0.
 Results: more than half of the subjects (65.6%) are male. The mean age of the subjects was 60.46±10.06 years. More than half of the subjects (62.5%) had a normal body mass index. The average length of suffering from diabetes mellitus was 5.48 ± 2.26 years. Half had a history of smoking (59.4%), a small proportion of subjects had hypertension (21.9%), hypercholesterolemia (6.3%) and neuropathy (12.5%). More than half of the subjects (53.1%) had immunopathies. There is a correlation between the popliteal PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.463) and a negative direction. There is a correlation between the PSV dorsali pedis value and the Wagner score in diabetic ulcer patients (p<0.05), with a strong correlation strength (r=-0.720) and in a negative direction. Furthermore, there is a correlation between the posterior tibial PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.530) and a negative direction.
 Conclusion: There is a correlation between the popliteal, tibialis posterior, dorsalis pedis PSV value and the Wagner score in diabetic foot ulcer patient

Background: Presently 62 million Indians are diabetics and these numbers are on the rise. Amongst chronic complications of uncontrolled diabetes, foot ulcer is one. Diabetes is the leading cause of non-traumatic lower extremity amputation in developing countries with risk being 15 to 46 times higher. Infections are predominantly polymicrobial, predominantly Aerobic Gram-Positive cocci with higher incidence of anaerobic species and fungal infections. Treatment of fungal infections in diabetic foot ulcers might reduce the disability, morbidity and mortality in diabetic patients.Methods: A total of 100 diabetic foot ulcer patients admitted or who visited to JSS Hospital over a period of 2 years, meeting the inclusion/exclusion criteria of the study, formed the study population. Detailed history, clinical evaluation & necessary investigations were done. Fungal isolation from the ulcer done by 10% KOH study, Gram stain, SDA culture and slide culture methods. Positive patients were treated with antifungal agents. Outcome of the disease studied based on ulcer progression, wound healing and tissue amputations.Results: Polymicrobial flora in diabetic foot ulcers was seen (137 organisms in 100 subjects), predominantly Enterobacteriaceae and Pseudomonas. Prevalence of fungal infections in present study was 19%, of which Candida species was the commonest.Conclusions: Present study signifies the need of mycological evaluation of nonhealing diabetic ulcer, with poor progression despite antibacterial therapy & foot care, introduction of antifungal treatment for proved fungal infections in diabetic foot ulcers, considering fungal infection as significant risk factor.

Diabetes Mellitus is a non-communicable disease that continues to experience an increase in the number of cases with high mortality and morbidity rates, expected to triple by the year 2030. In the long term, it can lead to microvascular, macrovascular, and neuropathic complications such as peripheral vascular disease, indicating abnormalities in the lower limbs, manifested as diabetic ulcers. The research aims to determine the Influence of Diabetic Foot Exercises on the Risk of Diabetic Ulcers in Patients with Diabetes Mellitus at Sukosari Community Health Center in Babadan Subdistrict, Ponorogo Regency. The research design is a pre-experimental study with a One Group Pretest-Posttest approach. The study was conducted from June to August 2023. The population consisted of all Diabetes Mellitus patients at Sukosari Community Health Center in Babadan. Sample of 30 respondents was selected using purposive sampling. The independent variable was the risk of diabetic ulcers, and the dependent variable was diabetic foot exercises. The observation instrument used was Inlow's 60-second diabetic foot screening tool. Statistical analysis was performed using the Wilcoxon signed-rank test through SPSS with α = 0.05. The research results showed that the risk of diabetic ulcers before diabetic foot exercises, more than half of the respondents (63.3%), had a moderate category, and 43.3% had a mild category. There is an influence of Diabetic Foot Exercises on the Risk of Diabetic Ulcers in Patients with Diabetes Mellitus at Sukosari Community Health Center in Babadan Subdistrict, Ponorogo Regency, with a p-value of 0.000 ≤ α 0.05. Diabetic foot exercises can be performed independently, without the need for equipment, and at no cost. It is hoped that patients with Diabetes Mellitus can perform them regularly, systematically, and continuously, with the expectation of reducing the risk of diabetic ulcers.

Introduction: Diabetic Mellitus type 2 is most common causes are foot ulcer; Infections include abscess, necrotizing, fasciitis, gangrene, arthritis, tendonitis, cellulitis, osteomyelitis and eventually lead to the development of limb amputation.Aims and Objectives: This study carried out to determine the patterns of infection in diabetic foot ulcers with special reference to the susceptibility and drug resistant isolates.Materials and Methods: Samples were collected from 199 diabetic foot ulcers patients by using pus swab, tissue, and exudates in sterile containers and processed to using standard microbiological techniques.Results: A total of 441 bacterial isolates were obtained from 199 patients with diabetic foot ulcers. A maximum number of patients were in the age group of 45 to 64 years and male predominant compared to female. Most of the isolates recovered according to Wagner classification system in DFU (Diabetic foot ulcer) >4cm2, >7.0 HbA1C and blood urea >30 mg/dl and serum creatinine >1.3mg/dl. 55% isolates of non-lactose fermenting Gram negative bacteria were more prevalent than 45% isolates of lactose fermenting Gram negative bacteria. The most commonly found isolate was Pseudomonas aeruginosa (39.6%), Escherichia coli (17.46%), Acinetobacter species (15.41%), Proteus species (12.47%), and Klebsiella species (9.75%) respectively. Antimicrobial susceptibility of the Gram negative bacteria was also studied. ESBL producing most common bacteria was Klebsiella species and Citrobacter species in this study than Escherichia coli and Enterobacter species.Conclusion: This study shows NLF predominant than LF GNB among the isolates from the diabetic foot ulcers. Antimicrobial susceptibility result of this study suggests that pathogens having susceptible to Imipenem and Piperacillin/ tazobactam were sensitive against LF, NLF-GNB and also ESBL producing bacteria. Colistin is the drug of choice multi-drug resistant (MDR) pathogens. Surveillance and monitoring on the antibiotic susceptibility pattern of the isolates will be helpful in determining the drugs for the empirical treatment of diabetic ulcers.

To investigate the characteristics of and the risk factors for pulmonary fungal infection in patients with pulmonary tuberculosis (PT). A retrospective analysis was conducted on the clinical data of 218 PT patients treated at Beijing Luhe Hospital Affiliated with Capital Medical University from May 2022 to May 2024. Based on the presence or absence of fungal infection, these 218 patients were assigned to an infection group (n=87) or a non-infection group (n=131). Clinical baseline data, pulmonary fungal infection status ten days after admission, clinical symptoms on the first day of admission, and serum protein and hemoglobin levels were compared between the two groups. Logistic regression analysis was conducted to identify independent risk factors for pulmonary fungal infection in PT patients. A receiver operating characteristic (ROC) curve was generated to evaluate the predictive performance of these independent risk factors. Among the 218 PT patients included, 87 (39.91%) had fungal infections. A total of 210 fungal strains were isolated and cultured from the infection group, with Candida albicans accounting for the highest proportion (42.65%), followed by candida tropicalis (20.59%) and Candida glabrata (17.65%). The infection group exhibited significantly higher rates of cough, fever, anemia, and pulmonary rales compared to the non-infection group (all P<0.05). The infection group showed significantly lower levels of serum protein and hemoglobin than the non-infection group (P<0.0001). Multivariate analysis identified history of smoking, disease course, duration of corticosteroid use, invasive procedure, serum protein level, and hemoglobin level as independent factors for fungal infection in PT patients. ROC curve analysis indicated that serum protein levels had the highest accuracy and area under the curve (AUC) value, while smoking history and hemoglobin levels performed less well in the model. This study found a high rate of pulmonary fungal infections among PT patients, with Candida albicans being the most prevalent, followed by candida tropicalis and Candida glabrata. A history of smoking, a prolonged disease course, invasive procedures, extended corticosteroid use, and low serum protein and hemoglobin levels are independent factors for fungal infection in PT patients.

Background: Many chronic nonhealing diabetic foot ulcers (DFUs) with increased rates of amputation are frequently associated with fungal infections. Purpose: To evaluate the prevalence, profile, and risk factors of developing a fungal infection in patients with DFU. Methods: This prospective observational study was carried out from October 2018 to July 2020. All adult patients with DFUs admitted to the surgery ward were recruited. Patients on antifungal therapy or who received such therapy within 6 weeks prior to admission were excluded. Three deep tissue samples were sent for bacterial culture, fungal culture, and histopathological examination of fungal elements. Results: A total of 251 patients were enrolled in the study. Of the 23.3% of patients with positive fungal growth (n = 47/202), 2% (n = 4/202) had pure fungal growth and 21.3% (n = 43/202) had mixed growth with bacteria in their ulcers (ie, non-contaminated samples). A significant association was found between wound grade (P = .027), ulcer duration (P = .028), and positive fungal growth in DFUs. Conclusions: In this study, the prevalence of fungal infection in DFUs was 23.3%; Candida tropicalis (27.08%) was the most common isolate, followed by C. albicans (20.83%). The rate of fungal infections was high in patients with mild diabetic foot infection or DFU of 7 to 14 days’ duration.

The role of foot self-care behavior on developing foot ulcers in diabetic patients with peripheral neuropathy: A prospective study

To study the prevalence of pathogenic organisms and the prevalence and outcome of methicillin-resistant Staphylococcus aureus (MRSA) infection in foot ulcers in diabetic patients. A retrospective analysis of wound swabs taken from infected foot ulcers in diabetic patients, selected from an outpatient diabetic foot clinic. Seventy-five patients (79 ulcers) with positive wound swabs were included. Size of ulcer and time to healing, in particular for MRSA-infected ulcers, were measured in all patients. Gram-positive aerobic bacteria were the commonest micro-organism isolated (56.7%) followed by gram-negative aerobic bacteria and anaerobes (29.8% and 13.5%, respectively). Of the gram-positive aerobes, S. aureus was found most frequently and 40% were MRSA. MRSA was isolated more commonly in patients treated with antibiotics prior to the swab compared to those who had not received antibiotics (P = 0.01). Patients whose foot ulcers were infected by MRSA had longer healing time than patients whose ulcers were infected by methicillin-sensitive S. aureus (mean (range) 35.4 (19-64) and 17.8 (8-24) weeks, respectively, P = 0.03). MRSA infection is common in diabetic foot ulcers and is associated with previous antibiotic treatment and prolonged time to healing. Further studies are required to assess the need for antibiotics in treating foot ulcers in diabetes and to assess the optimum therapeutic approach to this problem.

Background:Diabetes is a metabolic disease that is taking an epidemic proportion around the world. The occurrence of microvascular complications and diabetic foot ulcer is associated with an increased mortality and morbidity incidence, which is the most serious complication of this disease, which significantly reduce the quality of patient life.Objective.The aim of the study was to determine the correlation of extracutaneous microvascular complications with diabetic foot ulcer in patients with type 2 diabetes.Method.The study was prospective, and included 160 patients with type 2 diabetes. It was conducted at the University Clinical Center of the Republic of Srpska in the period from January 2016 until December 2019. The respondents were adults, of both sexes, suffering from type 2 diabetes, in whom complications of this disease are present. Glycemic control was established based on a target HbA1c value of 7%.Results. Of the 160 patients in the study, 53.8% were men and 46.2% were women. The average age of the patients was 70.11%±10.05 years. Extracutaneous microvascular complications were present in 85 patients (53.1%); of which 30.2% had well-regulated glycemia (HbA1c≤7.0%), while 61.5% (p<0.001) had unregulated glycemia (HbA1c≥7.0). Polyneuropathy was present in 23.3% of patients with HbA1c≤7.0%, while 41.0% of patients had HbA1c≥7.0% (p<0.043). Nephropathy with HbA1c≤7.0% was present in 36.8% of cases compared to patients with HbA1c≥7.0 in whom the prevalence was 36.8% (p<0.004). Out of total, 25.6% had retinopathy with HbA1c≤7.0%, while in 41.9% of patients with HbA1c≥7.0% (p <0.067). Diabetic ulcer foot was present in 13 patients with HbA1c≥7 (11.1%) compared to patients with HbA1c≤7.0% where there was no occurrence of this complication 0.0% (p<0.021). At the same time, 5.6% of patients had a diabetic foot ulcer with polyneuropathy (p=0.010), 4.4% had neuropathy (p=0.058) and 5.6% had retinopathy (p=0.014).Conclusion:The high incidence of extracutaneous microvascular complications and diabetic foot ulcer in patients with type 2 diabetes requires a multidisciplinary approach of medical professionals that includes prevention of risk factors and good regulation of glycemia.

The World Health Organisation estimated that in the year 2000, 150 million people had diabetes mellitus, and it is predicted that this number will rise to 366 million by the year 2030.[1][1] Neuropathy is a common complication of diabetes and is characterised by a progressive loss of peripheral

In a cross-sectional survey, designed to detect all patients with current chronic leg ulcers, 27% of the patients had diabetes mellitus. The outcome for the 104 examined diabetic patients has been evaluated and compared with the 278 nondiabetic patients. The purpose was to establish the prevalence of leg ulcers among diabetic patients and to assess potential causes. The point prevalence was calculated by extrapolating the leg ulcer frequency to the total diabetic population in the studied area. The point prevalence for active leg ulcers (including foot ulcers) in diabetic patients was 3.5% (95% CI 2.8-4.2). Ulcers above the malleoli were almost as common as foot ulcers. Peripheral vascular disease was present in 67% of all ulcerated legs in patients with diabetes compared to 42% in nondiabetic patients (p < 0.001). In 72% of foot ulcers in diabetic patients arterial impairment was judged to be a contributing aetiological factor and in nondiabetic patients 45% (p < 0.001). Ulcers solely attributed to possible neuropathy were less common (15%). Ulcers with multifactorial causes were common above the malleoli. This survey has given the size of the problem and indicates macroangiopathy to be the dominating factor responsible for slow or nonhealing ulcers in diabetic patients. Objective assessment of arterial circulation is mandatory and signs of arterial impairment require consultation with a vascular surgeon.

Background/Aims Interleukin (IL)-17 plays a role in host defense against common extracellular pathogens, including fungi. Treatment with IL-17 inhibitors has been associated with fungal infections. Ixekizumab (IXE) is an anti-IL-17A monoclonal antibody approved for the treatment of psoriasis (PsO) in adults and children, psoriatic arthritis (PsA) in adults, and axial spondyloarthritis (axSpA) in adults. This integrated post-hoc analysis investigates treatment-emergent fungal infections in IXE-treated patients across the approved indications. Methods Safety data on fungal infections were pooled from the IXE paediatric and adult clinical trial programs, comprising 26 clinical studies. Here, we describe the types of fungal infections, number of infections, recurrence (defined by at least two separate events irrespective of location), severity (defined at the investigator’s discretion), events that lead to discontinuation, and anti-fungal medications. Data are presented as frequency or incidence rate per 100 person-years (IR). Results Fungal infections were reported in patients with PsO (IR = 4.0), PsA (IR = 4.1), and axSpA (IR = 2.7). Across indications, most fungal infections were not recurrent and were classified as mild or moderate in severity. There were few severe fungal infections in patients with PsO (IR = 0.1), PsA (IR = 0.0), and axSpA (IR = 0.0). Most fungal infections in patients with PsO, PsA, and axSpA were candidiasis (IR = 1.9, IR = 2.5, IR = 1.4, respectively) and superficial dermatophytosis (IR = 1.5, IR = 1.0, IR = 1.0, respectively). No cases of subcutaneous and systemic mycosis infections were reported. The proportions of patients with PsO, PsA, and axSpA who received a topical vs systemic anti-fungal medication were 53.6% vs 1.1%, 47.8% vs 0.0%, and 45.6% vs 3.5%, respectively (Table 1). Most fungal infections did not lead to discontinuation of IXE (Table 1). Conclusion Consistent with previously disclosed IXE data, the majority of treatment-emergent fungal infections observed in patients with PsO, PsA, or axSpA treated with IXE were: (i) not recurrent; (ii) mild or moderate in severity, (iii) associated with candidiasis and superficial dermatophytosis, (iv) managed with topical anti-fungal medications or no treatment reported, and (v) not leading to drug discontinuation. Disclosure S. Schwartzman: Corporate appointments; SS reports being a board member of the National Psoriasis Foundation. Consultancies; S. Schwartzman has served as a speaker and/or consultant for AbbVie, Janssen, Eli Lilly and Company, Pfizer, UCB, Myriad, Novartis, Regeneron, Sanofi, Stelexis, Jubilant, Teijin. L. Puig: Corporate appointments; Board member of the International Psoriasis Council. Consultancies; AbbVie, Almirall, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Leo Pharma, Eli Lilly and Company, Novartis, Pfizer, Sandoz, Sanofi, UCB. Honoraria; Boehringer Ingelheim, Janssen, Eli Lilly and Company, Novartis, UCB, travel support from Janssen, Eli Lilly and Company, Pfizer, UCB. Grants/research support; L. Puig reports receiving grants from AbbVie, Almirall, Amgen, Boehringer Ingelheim, Leo Pharma, Eli Lilly and Company, Novartis, Pfizer, Sanofi, UCB. A.D. Cohen: Honoraria; AbbVie, Amgen, Boehringer Ingelheim, Dexcel Pharma; Janssen, Eli Lilly and Company, Neopharm, Novartis, Perrigo, Pfizer, Rafa. Grants/research support; A. D. Cohen has served on advisory board for Samsung, and reports receiving grants from AbbVie, Janssen, Novartis, Pfizer, travel support from AbbVie. S. Khattri: Consultancies; S. Khattri reports being part of Eli Lilly and Company speaker’s bureau, receiving consulting fees and honoraria from Eli Lilly and Company, AbbVie, UCB, Janssen, BI, Regeneron, Leo Pharma. C. Jossart: Shareholder/stock ownership; C. Jossart is a stockholder of Eli Lilly and Company and was an employee of Eli Lilly and Company when this study was conducted. C. Diaz: Shareholder/stock ownership; C. Diaz is employee and stockholder of Eli Lilly and Company. A. Garrelts: Shareholder/stock ownership; A. Garrelts is employee and stockholder of Eli Lilly and Company. D. Zhu: Shareholder/stock ownership; D. Zhu is employee and stockholder of Eli Lilly and Company. N. Eberhart: Shareholder/stock ownership; N. Eberhart is employee and stockholder of Eli Lilly and Company. A. Eleftheriadi: Shareholder/stock ownership; A. Eleftheriadi is employee and stockholder of Eli Lilly and Company. N. Tangsirisap: Shareholder/stock ownership; N. Tangsirisap is employee and stockholder of Eli Lilly and Company. C. Schuster: Shareholder/stock ownership; C. Schuster is an employee and stockholder of Eli Lilly and Company. A.B. Gottlieb: Consultancies; Xbiotech (stock options for an RA project). Honoraria; Amgen, AnaptysBio, Avotres Therapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Dice Therapuetics, Dermavant, Lilly, Janssen, Leo, Pharma, Novartis, Pfizer, Sanofi, Sun Pharma, UCB Pharma. Grants/research support; AnaptysBio, Moonlake Immunotherapeutics, Novartis, BMS, and UCB Pharma; all funds go to the Icahn School of Medicine at Mount Sinai. M. Sheesh: Shareholder/stock ownership; MS is a full-time employee and minor share holder of Eli-Lilly and Company.

Foot ulceration in diabetic patients is commonly occurred and leads to amputation of the leg. Furthermore, pathogenesis of the foot ulceration is not only clinical presentation variable and complicated, but also required medical management at early stage. However, patients, initially, have been neglected the condition of their feet because the initial ulcer does not have a major effect on the patient’s life. Therefore, the foot ulceration becomes serious, and then the patients come to treat in the hospital. Therefore, early diagnosis is important for the treatment of the foot ulceration in diabetic patients. Recently, the changes in mechanical properties (Elastic moduli) of the plantar tissue were found to be important factors in the diagnosis of diabetic foot ulceration. In this paper, we, therefore, developed a monitoring system that can measure the elastic moduli of the plantar tissue of patients, which can be used to check the condition of patients’ feet with monitoring the elastic moduli change of plantar tissue. The system was designed to be portable and easy to use, and is consists of probe, force sensor, linear actuator, micro control unit, display module, battery, and housing. To validate the system performance, we carried out palpation experiments with applying 3mm and 5mm palpation depths to tissue phantom. In addition, we measured the reaction forces according to the applied palpations and estimated the elastic moduli of the tissue phantom. We also performed the experiments on the plantar tissue of human at the same experimental condition and estimated the elastic moduli of the plantar tissue. From the results, the estimated elastic moduli on tissue phantom show similar value even if the palpation depths are different. The results were similar when the plantar tissues were tested, which means that the system can be used to monitor the foot ulceration in diabetic patients.