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Table 1 The modified Simms’ classification

From: Laser therapy for onychomycosis in patients with diabetes at risk for foot complications: study protocol for a randomized, double-blind, controlled trial (LASER-1)

Simm’s classification Risk profile Control frequency
Simm’s 0 No loss of PS or PAV Once in 12 months
Simm’s 1 Loss of PS or PAD, Without signs of local increased pressure Once in 6 months
Simm’s 2 Loss of PS and PAD. Loss of PS and/or PAD in combination with signs of local increased pressure. Once in 3 months
Simm’s 3 Ulcer or amputation in the medical history Once in 1 to 3 months
  1. PAD, peripheral arterial disease; PS, protective sensibility.