Lipid peroxidation is known to accelerate aging and microvascular lesions in diabetic patients. We studied the acute influence of improved glycemic control on the concentrations of plasma lipid peroxidation intermediates [malondialdehydes (MDA), organic hydroperoxides (OHP)] in ketotic insulin-dependent diabetic patients, as well as the interplay of enzymes such as glutathione peroxidase (GPX) and CuZn superoxide dismutase (CuZn-SOD), and trace elements (Zn, Se, Cu) postulated to be involved in free radical protection. These plasma components were measured on the first day of hospitalization (T0) and when the patient had attained a stable glycemic state after continuous insulin treatment (T1). Plasma MDA and OHP concentrations were high at the beginning of the study but approached reference values after glycemic equilibration. Plasma zinc concentrations were significantly (P < 0.05) decreased during the ketotic state, but also approached reference values with glycemic equilibration. Plasma selenium concentrations and GPX activity were relatively unchanged between T0 and T1. Erythrocyte GPX activity measured at T1 in six patients was below the reference values, whereas CuZn-SOD activity was not affected. Our results show that enhanced lipid peroxidation is associated with decreased zinc plasma concentrations in ketotic patients and underline the beneficial effects of continuous insulin infusion. The mechanisms involved are still unclear but may indicate the importance of extracellular zinc transfer secondary to glycemic disorders.

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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.

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