Review Question - QID 212816

A 65-year-old man presents to the clinic with a chronic, non-healing ulcer on the medial plantar surface of his right foot. He states that he thinks the ulcer has been there for at least 6 months. Sometimes it heals if he does not wear shoes that rub on it but will reopen if he walks a lot. He denies pain or pruritis. His medical history includes atrial fibrillation, diabetes complicated by diabetic retinopathy, hypertension, and hypercholesterolemia. His medications include carvedilol, insulin, lisinopril, gabapentin, and atorvastatin. Upon physical examination, the right foot is warm to touch with mild non-pitting edema. There is diminished vibratory sensation at the level of the right ankle as well as diminished sharp/dull sensation. Proprioception of the first metatarsophalangeal joint is intact bilaterally. Figure A shows an image of the right foot. Which of the following describes the finding seen in Figure A?