Most ulcers can be classified as neuropathic, ischaemic or neuroischaemic (Figures 21.4 – 21.6). Neuropathic foot ulcers frequently occur on the plantar surface of the foot in high-pressure areas, e.g. overlying the metatarsal heads, or in other areas overlying a bony deformity. They account for > 50% of diabetic foot ulcers and are often painless with a ‘punched out’ appearance. Ischaemic or neuroischaemic ulcers are more common on the tips of the toes or the lateral border of the foot. Neuropathic ulcers with overlying callus and necrosis should be regularly debrided, and infection should be treated promptly with antibiotics.