A 60-year-old woman with a history of severe depression presented with erysipelas of the lower limbs. Her feet were malodorous, with thickened skin, a leathery texture, hyperkeratosis and fissuring. Severe onychogryphosis was also observed (Box). She lived in a country house with her son, who was developmentally delayed, in conditions of poor hygiene, and refused any outside assistance.
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