Search

Periungual fibromas may be acquired lesions or they may be associated with tuberous sclerosis or von Recklinghausen's Disease. Such tumors are comparatively rare benign dermatological entities. Periungual fibromas associated with the posterior nail fold have a potential for inducing deforming nail deformity. Pain resulting from the growth is due to concentration of pressures which may be placed on the nail matrix and contiguous soft tissue structures. This is further complicated by compression developed within the toe box of the shoe. The preferred treatment in symptomatic cases is that of complete surgical excision of the entire lesion. The present study presents such a case, together with histopathological features of this type of growth, with special emphasis on the subcellular features of the neoplasm.

Angioleiomyoma is a benign soft tissue tumor that originates from the smooth muscle of blood vessels. Such lesions must be differentiated from fibroma, lipoma, ganglionic cyst, glomus tumor, neurofibroma, leiomyosarcoma, and phlebitis. These masses appear as encapsulated, glistening nodules that ordinarily respond well to surgical excision. It will be the intent of the present study to review the clinical and histological characteristics of angioleiomyomas as they may appear in podiatric practice.

Physicians have long recognized that systemic diseases manifest themselves in the foot. The podiatric physician can play a crucial role in the identification of such pathologic processes. Consultation with various subspecialties, along with sensory, motor and neurologic examinations often are paramount. This article will present a case of a meningioma identified by careful podiatric evaluation and consultation with internal medicine, neurology, and neurosurgery.

The use of silicone elastomer implants in podiatric surgical practice is presently a well accepted treatment modality. However, there are instances of failure, and the present study describes a total collapse and fragmentation of a metatarsophalangeal joint prosthesis. Defects are demonstrated by scanning electron microscopy, while physical and chemical reasons for the occurrence as stated in the current literature are reviewed.

Giant cell tumors are benign neoplasms of unknown etiology that have a histologically distinctive, multinucleated giant cell tumor associated. Microscopic evaluation is essential for accurate diagnosis. The treatment of choice is total surgical excision.

Although systemic anaphylactic reactions are relatively uncommon, the podiatric physician must be familiar with the precipitating causes, clinical picture, and emergency management. The authors discuss the pathophysiology of anaphylaxis and the typical agents that trigger the response. The clinical features are presented, along with guidelines in establishing a differential diagnosis. Therapeutic measures, aimed at stabilizing the patient and curtailing the extent of the reaction, are also addressed.

Ainhum (dactylolysis spontanea) is a poorly understood disease characterized by spontaneous autoamputation of the fifth toe. Its incidence is highest among blacks and in the tropical and subtropical climates. The present study is the first to present certain gross and semimicroscopic findings. Moreover, scanning electron microscopic and histochemical data are presented and these reportings are believed to be unique. Hyperkeratosis and parakeratosis, together with elongation of the epidermal rete pegs and acanthosis, are observed and these findings are associated with the presence of numerous fibroblasts and wound repair phenomena. The leukocytic infiltrate is identified as being principally of T lymphocyte type, suggesting the existence of an unknown immunologic response. Relevant intraoperative data, radiographs, and light microscopy, as well as transmission electron microscopy, have been reported in this study. The spontaneous amputation of the fifth toe, designated as dactylolysis spontanea, has no known etiology, and no treatment short of amputation. The worldwide incidence of this condition is rare. Two cases have been observed at the Baltimore Veterans Administration Medical Center in the last 5 years. One patient is in an early stage of the disease. The present study involves the single instance in which amputation was elected as the treatment of choice. Because the occurrence of ainhum (dactylolysis spontanea) is rare, discussion of the disease is lacking in medical literature. It is the intent of the present study to be the definitive analysis of clinical, surgical, and surgical-pathologic data of this rare disease. Unique applications of semimicroscopic, histochemical, and light microscopic findings, as well as transmission and electron microscopy, will be presented. Speculation as to the implications of immunologic and/or wound repair responses as implicated in ainhum needs to be explored.

Psychogenic seizures can mimic epileptic conditions and are often difficult to diagnose. The present study reviews one such unusual occurrence in a patient having a complex psychiatric history who required surgery for the removal of a ganglionic cyst in her foot. The differential diagnosis and treatment of psychogenic seizures is discussed.