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Gout. Presented by Dr. Bernard Appel, Lynn, Mass.
W. C., an unemployed white man aged 65, presents a lesion of the left great toe of thirteen years' duration.
The patient complains of attacks of pain and swelling of the toe. Ulcers frequently form, especially on the plantar aspect. Three years ago a draining ulcer developed near the end of the toe on the plantar aspect, and this ulcer has never completely healed. The ulcers of themselves have been practically painless, although the toe when acutely swollen is painful. He was a patient at the Danvers State Hospital from 1928 to 1939 for alcoholic psychosis and was discharged improved. Examination shows the left great toe greatly swollen, bright red and tender. A healing nonpainful round punched-out ulcer approximately 1 cm. in diameter is present on the plantar aspect of the terminal phalanx.
The urine was normal. The Wassermann reaction
Swartz JH, Thurmon FM. NEW ENGLAND DERMATOLOGICAL SOCIETY. Arch Derm Syphilol. 1944;50(6):433–439. doi:10.1001/archderm.1944.01510180083019
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