Erythema exsudativum multiforme is an immunologically mediated skin reaction or a reaction to viruses or bacteria (10), classified in the group of type-IV delayed cell-mediated hypersensitivity. The minor form is localized on the skin and the mucosa are not involved (1, 9). The typical skin sign is herpes iris, or target lesions with a red to reddish-blue color. The localization of the changes occur in photo-exposed areas. The main causes are various drugs, food containing some additives, bacteria, especially streptococcus, and some viruses, such

Background: Malum perforans pedis is a chronic disease characterized by a punched out ulceration that may enlarge. The ulcer is localisated in a foot. It is a complication of the primary disease of the different origin that is always presented with a vaculopathies or neuropathies, and is common in diabetic patients. Malum perforans pedis appears in a sole of the foot and mostly occurs with no pain. The disease is mostly caused by the pressing of the underlain bone and a chronic trauma on a poor blood flow of the tissue. The treatment consists: on a treatment of the primary disease-vaculopathy and neuropathy; the local treatment includes treatment of the infection and the wound treatment through surgery and skin grafting. Case presentation: This paper presents a case of a 49 year old woman with the ulceration on a sole of the left foot that did appeared before four months. The patient claims that the changes began after wearing shoes that hurt her foot. The patient also claims that during the past year she had some signs of diabetes and the measure of the blood sugar shows high levels. The patient also gives interesting data that during the last few years she have had used cosmetics which contained mercury. Conclusions: Malum perforans pedis is a disease where the patient loses the feeling of pain and the chronic trauma causes the injury and following that during the time the defect in a skin enlarges and makes a trophic ulcer in a various size and form. It also depends on a microangiopathies due to diabetes and arteriosclerosis.

Atrophoderma of Pasini and Pierini is a skin atrophy presenting as single or multiple sharply demarcated, hyperpigmented, non-indurated patches, with a slight depression of the skin, that can converge and form a confluent area with atrophy as a consequence. The condition was first described by Pasini in 1923 and subsequently by Pierini in 1936. They distinguished this form of atrophy from other diseases and conditions in which the atrophy is morphologically and clinically different. The disease was initially associated with Borrelia burgdorferi infection; however, at present, various theories have emerged for the appearance of the disease, linked to genetic, neurogenetic, and immunological factors. Here we present a patient that was admitted to the hospital due to disseminated lesions on the skin of the lower limbs, with slightly pigmented and atrophic skin along with irregular borders varying in size, from several mm to a few cm, clearly demarcated from the healthy skin, with no history of a tick bite or a family history of similar skin disorders.

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Lyme borreliosis is an infective disease that is usually transmitted to humans via biting by bacteria-infected Ixodes tick. The disease is multisystemic and the affected organs are the skin (Erythema migrans), nervous system, eyes, heart and joints. Borrelia burgdorferi is the bacterium that causes borreliosis and the hosts are rodents of the genus Apodemus. In the Balkan region, Ixodes ricinus is the most representative vector. A bite from an infected insect is the most common mode of transmitting Borrelia; however, transplacental transmission has also been documented. Pathogenesis of the disease consists of both direct and indirect mechanisms of immunological reactions which result in the production of IgM antibodies to Borrelia in the first 3-6 weeks, and production of IgG class after 6 weeks. Many skin diseases and skin symptoms mimicking Lyme borreliosis, such as dermatomycosis, erysipelas, and undefined hyperpigmentation must be elaborated and considered for borreliosis, as skin symptoms of borreliosis can imitate many of them.