Hi, The most probable causes I can think about area as follows: Some sort of systemic infection. Malaria or so. Anxiety and stress. All this can be diagnosed by the following ways: Get the recent blood sugars, urea, creatinine thyroid functions. Send the blood samples for culture and sensitivity if there is fever or so. Consult a Physician for clinical evaluation, examination and proper management. Counselling may be needed if all the reports are normal. Also to consider diabetic neuropathy as probable cause and medications as needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, General Surgeon