I am just going to tell you what this one is because I had to get help from Dermatology to figure it out. I was treating the man for a diabetic foot ulcer on the other foot when he came in with this new lesion on the contralateral great toe that had developed over night. He has atrial fibrillation so as a result he is on Coumadin.
Coumadin necrosis
This is Coumadin necrosis. It can be quite horrific, but thankfully on this man it was limited to his toe.