I walked into my treatment room today to find that my patien | Figure 1

I walked into my treatment room today to find that my patient had his leg dangling over the edge of the chair. His toes had a deep red discoloration. He mentioned that the small wound on his foot has become very painful and that, when in bed, he needs to hang his leg over the bed to sleep. As I elevated his foot on to the treatment chair, his foot turned white. The wound became too painful to touch. These pictures are a re-creation and not as dramatic as when I first witnessed them. Thoughts?

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60-year-old gentleman presented to my office yesterday requesting a "cortisone injection." Not surprisingly, he has right foot pain. He remembered that I gave him an injection for a neutoma in 2009 with good results. He is not diabetic. He is under the care of a vascular surgeon at a local wound care center. Wound VAC on medial ankle for non-healing venous stasis ulcer. Has undergone RF ablation for venous disease. The only pulse I could identify is a weak lateral tarsal artery. I sent him back to his vascular surgeon. He was upset that I would not give him the injection. Comments?

In 2014, a 62-year-old man came to my office with a concern about an enlarging "mole" on the lateral aspect of his left foot that he first noticed in 1996. His PCP referred him for a Derm consult in 2008, but he did not go because he had no insurance. He sought treatment because it had become painful with bleeding and a recent "rash."

pt teen male, was at a jump park, when he "over shot" the trampoline, causing him to stick out his leg to catch himself. The foot rolled, and pt heard an audible "bang." The pts grandfather is a peds doc, and thought he had an inversion sprain. The pt walked around for 2 years on the ankle, came for eval when he had continual pain and swelling. Whats involved here? What is your dx and tx?

OK. So a few weeks back I posted on here and my patient who I treat for other reasons came into his appointment complaining of a sore leg. He showed me it was red and swollen. I advised him to go to his G. P. He was very reluctant to go but his wife managed to persuade him. He ended up over the hospital and was told he had cellulitis and an ulcer forming. He was put on I. V antibiotics but unfortunately discharged himself the next morning(patient is alcohol dependant) on coming back to see me today I asked about his leg and he showed me this.. I have urged him to go over the hospital but he just won't. Please excuse my ignorance as my expertise is mental health. My question to you is what will happen to my patient if he does not go to the hospital for treatment?

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A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?