A 37-year-old man presented with a 2-week history of fever and thoracic pain. On physical examination, he presented a nonpruritic skin rash (0.2–1-cm nontender pink papules) on the trunk (figure 1a), upper extremities, face and soles of the feet, which had developed about 2 months previously. He also had multiple palpable and painful lymph nodes. Additional history revealed that the patient had...

BACKGROUND Patients with diabetic polyneuropathy (DPN) are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced by DPN related muscle weakness are the origin of the elevated plantar pressures. METHODS Three ...

Claw trimming every four to six months has become a routine procedure for the majority of high yielding housed dairy cows. Various methods have been described, but the Dutch Five Step method (Toussaint Raven 1985) is probably the most widely used approach around the world and has been the basis for most research. Despite being the most commonly used protocol internationally, the Dutch Five Step...

Carcinoma cuniculatum (CC) is a rare subtype of verrucous carcinoma usually affecting the sole of the foot. It was first described in the English-language medical literature by Aird et al in 1954. The incidence of CC worldwide is unknown. It is known to commonly affect males (79-89% of the patients) in their fifties. Carcinoma cuniculatum can arise on chronic ulcer or on recalcitrant plantar wa...

ALEXANDER THE GREAT DIED AT THE age of 32 years, with acute abdominal pain that began after several days of binge drinking. Might it have been from a perforated peptic ulcer? Founding a great empire may be an extraordinary example of life stress, but stress is currently out of fashion as a cause of ulcer. For many years the dominant etiologic model was exquisitely psychosomatic: a vulnerable pe...