Adenocarcinoma of the lung with metatarsal metastasis.

Foot pain is a most unusual presentation of metastatic malignancy. Metastases to the hands or feet (acrometastases) have been recognized in only a few cases. A 68-year-old male, with a history of chronic gout, presented with left foot pain for 3 months duration. After conservative treatment failed to relieve his pain, radiographic and eventual bone biopsy of a cystic lesion involving the first metatarsal head revealed a Grade IV adenocarcinoma.

Subcutaneous alternariosis of the foot in a patient on corticosteroids.

To the authors' knowledge, this is the first reported case of alternariosis involving the subcutaneous tissues of the foot. Podiatrists are likely to see more of this condition and other unusual fungi causing deep foot infections in the future because of the increasing population of immunocompromised patients.