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Psoriatic onychopachydermoperiostitis (POPP) syndrome characterizes a clinical variant of psoriatic arthritis originally described by Fournie et al in 1989. Both great toes are generally affected presenting with nail changes, painful swelling of the soft tissue close to the distal phalanx as well as specific radiologic changes such as periosteal reaction and bone erosions of the distal phalanges. Joint involvement is characteristically absent and classic psoriatic lesions may be associated. Painful symptoms may lead to severe functional and quality of life impairment. Traditional systemic treatment is generally frustrating. Here we report a female patient presenting POPP syndrome refractory to traditional systemic treatments and adalimumab, further presenting a favorable response to treatment with etanercept.

Study of a rare case of Elephantiasis Nostra in verrucous form on the dorsum of the foot of an 80 year-old male with a history of recurrent erysipelas infection. The vegetant, confluent lesions on the foot resemble Trumpet Coral (Caulastrea curvata).

Acroangiodermatitis, often known as pseudo-Kaposi sarcoma, is an uncommon angioproliferative entity related to chronic venous insufficiency, arteriovenous fistulae, paralysed limbs, amputation stumps, vascular syndromes and conditions associated with thrombosis. It presents most frequently as purple macules, papules or plaques in the dorsal aspects of the feet, especially the toes, and the malleoli. We report a case of acroangiodermatitis in the plantar aspect of the foot, misdiagnosed for two years, in which haematoxylin-eosin hystopathological stain and immunolabeling with CD34 histochemistry examination were decisive for diagnosis. Patient had chronic venous insufficiency. The lesion responded well to the treatment with a combination of leg elevation and compression.

Flegel's disease, also known as hyperkeratosis lenticularis perstans, is a rare skin disease characterized by small reddish-brown asymptomatic hyperkeratotic papules usually located on the lower extremities. The histopathological features are hyperorthokeratosis, epidermal atrophy and band-like inflammatory infiltrate in the superficial dermis. Treatment is generally ineffective. We report a case of hyperkeratosis lenticularis perstans that improved following excisional biopsy of the lesions.

Lichen sclerosus et atrophicus is a chronic disorder of the skin and mucosal surfaces, most commonly affecting the female genitalia. Few cases of lichen sclerosus et atrophicus confined to the feet and/or hands have been reported. We report a case of lichen sclerosus et atrophicus involving first the extremities and then the perigenital area.

Onycodystrophies are common problems in dermatologic practice. About 50% of dystrophic nails have a fungal cause, so it is very important to establish a correct diagnosis before treatment. In this article we relate the usefulness of an easydoing exam, free from pain, cheap and sensible. This exam is the histopathology of the nail keratin or nail clipping.

Pachydermodactyly is a rare form of digital fibromatosis involving the proximal portions of the fingers that usually affects young males. We present a 25-year-old male patient with a two year history of asymptomatic nodules in the fingers. Three months before the visit, he had observed similar lesions on the feet and right knee. Histopathological analysis showed thickened dermis with proliferation of fibroblasts and collagenous fibers, with deposition of mucinous material. This represents a rare case of pachydermodactyly of transgrediens form.

A case of acral skin necrosis in a 21-year-old farm workman, associated with Plasmodium falciparum malaria is reported. Patient presented jaundice, disorientation and delirium, high parasitemia, hypoglycemia, anemia, low platelets, and dark necrotic maculae surrounded by an erythematous halo, circumscribed to toes. After malaria treatment, the clinical evolution was uneventful and the skin lesions also improved without sequels. The possibility that some of the skin changes, eventually observed in malaria patients, may be related with responses to Plasmodium infection is emphasized.

Four cases of botryomycosis are presented. All patients had fistulous and ulcerated lesions of the lower limbs. Diagnosis was based on the clinical and laboratory findings (presence of grains on direct microscopy examination and positive bacterial cultures). All patients had osteomyelitis. Three were treated with antibiotics or sulfonamides (orientated by the antimicrobial susceptibility test) and were cured.

We report three familial cases of a particular type of ichthyosis bullosa. The clinical picture is different from bullous congenital ichthyosiform erythroderma, but the histologic and ultrastructural features are those of epidermolytic hyperkeratosis.

Ten cases of infantile acropustulosis were studied clinically, in laboratory and histopathologically. There was no racial predominance. In most of the cases the lesions started in the first 6 months of life and were located mainly on the feet severe itching. Was a constant symptom. Laboratory studies were negative for fungus, bacteria and acarus. Atopy was found in 20% of the cases and 30% of the families. Blood eosinophiles was found in 70% of the lesions.

The Author describes two cases of Jorge Lobo's disease, with disseminated lesions and plantar invasion, originating from Cruzeiro do Sul, state of Acre and Manaus, state of Amazonas. In both cases, the disease was of long duration, 30 and 55 years respectively. In the second patient described the disease began 9 years before Jorge Lobo described this condition. In spite of the duration of the illness in this patient 76 years of age, he was in good physical condition without any apparent suggesting dissemination of the mycosis.