IT IS I. EMILY YOUCIS

[ALFREDPAORN]

Folks, it is I. EMily YOucis. I know you have requestesd me to join your fine forum long ago.
And now I have, and trust me, i am much flattered and my stomach is all aflutter from your like of my movies. Really, it gives  me great joy that you like them.
I know though, that I have perhaps betrayed you. As you know, I have switched to spam.
Many hate my spam, but folks it is done out of frustration. I am at a crux in my life, folks, as much people are at this age. I've been feelin that damn void folks, feelin it even more because i've got the success and i've done my good ol;' show, yet satisfaction as we all know cannot come - and folks i've learned that, and folks i'm feelin that goddamned void. But folks the void aint that bad of afriend. I have spent so much of my life on the computer with my art. But now, folks, I want to go out and live. I want to explore and see this damned merica and see the backwoods and the rednecks and the juggalos and the metal kids and the trainyards and the dirt and the AIDS and i wanna get raped/murdered by it all baby YEAH BABY YEAH. so lately i've been setting off on my bike to find the dirt of this world and feel that void and get fucked under highway bridges by fyne crackhead homeless rednecks that look like kid rock and maybe get hepatitis C. Right now i've gotta leave the computer and ive gotta get fucked up.
But lemme tell you folks, i aint never fuckin done. cause nothin fills that void in the end like makin that dog scream. that dog that is Alfred. I've still got it folks but i need fucking feul. And that is why i must go see the shit. And learn more things. Yeh mayn the worlds' gonna feed to me alfred. I've been writin somethin for 2 years and folks it has only been gettin better.
But for now folks i just wanna do my damn spam and poarn. it's all i've got now.
So i request your service.
i've been trying to submit my metalocalypse hentai that turns into a commercial of Alfred as the Salesman sellling himself to you, exploiting those fine characters of metalocalypse as well as himself, Prostituting himself. ALl doing it through the power of cannibal corpse. i love that corpsey. It's a fine commercial and I honestly think it's quite good. It's dead on, it's pounding, I actuallly fuckin love it but the problem is no one lasts through the metalocalyspe hentai so they can see it. It keeps getting blammed and folks i'd love your help. Maybe you think i'm no good no more because of the shit i've been doin lately, maybe you'll help me no matter what.
But i request your service. Please vote 5 on POARN.
I'll let you know the date of when i am actually going to submit it when i figure it out.
But i shall tell you that i aint done folks, i haven't fallen to the ground and exploded in a suicide of spam. THE ALFRED WILL RISE AGIAN FOLKS, HE WILL. But first he must fall. fall hard into being jizzed on by poorly drawn metalocalypse characters.
Thank you for your time.

[sdrawkcab]

I thought you were an impostor, but then I saw that picture, and yeah.

[Wasim]

uh ok hi

[jjjjjjjjjj]

hello nic 2 see u welcome

[ansel]

welcome to this fine forum

[CoolDrMoney]

This is a very special treat!

[ZekeySpaceyLizard]

i love spam when its funny
and you make funny spam

[rtil]

whatever you make i'm sure we're all get a good kick out of it - and sometimes it's refreshing to take a little break from a big project. and welcome to my dojo

btw love that image haha

[anigen]

do you think you're better than me? huh, little man?

[Alta Don]

Welcome to the boards. Glad you joined

[DrRumack]

what squeef said also welcome to da forums we hope you stay long time

[Casey Pixmintro]

Hello and welcome. Shit, if it weren't for these guys, I never would have seen the Alfred movies. You have a gift, a fucking weird gift.

[f0d]

this girl is a saint

[Daveb0t]

Itchy and Painful Ulceration on the Penis
photo

A 61-year-old man presented with a five-day history of a penile ulceration. It began as an itchy, erythematous lesion and gradually became pigmented, blistered, and ulcerated (see accompanying figure). He had a history of benign prostatic hyperplasia for which he took tamsulosin (Flomax). He also had been taking ciprofloxacin (Cipro) during the preceding week to treat a urinary tract infection. He took no other prescription, over-the-counter, or herbal medications. The physical examination was normal except for the penile lesion. The patient denied any penile discharge and had one sexual partner who denied having any skin lesions or pruritus.

Question

Based on the patient's history and physical examination, which one of the following is the most likely diagnosis?

A. Syphilis.

B. Genital herpes.

C. Erythroplasia of Queyrat.

D. Fixed drug eruption.

E. Chancroid.

Discussion

The answer is D: Fixed drug eruption. The characteristic presentation is a pruritic or burning, sharply circumscribed, round-to-oval patch with violaceous or dusky erythema. The lesion appears within days to weeks of initiating a culprit drug and resolves after withdrawal of the medication. Lesions often recur at the same sites within hours of drug rechallenge and heal with residual hyperpigmentation. This eruption has a predilection for the face, sacral skin, genitalia, and acral locations. Bullous, ulcerative, or hemorrhagic components may develop occasionally. Less common variants are urticarial, erythematous, eczematous, or linear fixed drug eruption. Rarely, it may present as periorbital or generalized hypermelanosis.1

The most common causative agents of fixed drug eruption are antibiotics, in particular sulfonamides (trimethoprim/sulfamethoxazole [Bactrim, Septra]) and tetracycline. Others include penicillins, cephalosporins, clindamycin (Cleocin), antifungal agents, antimalarials, dapsone, fluoroquinolones, nonsteroidal anti-inflammatory drugs (e.g., acetaminophen, acetylsalicylic acid, ibuprofen [Motrin], indomethacin [Indocin], naproxen [Naprosyn], phenylbutazone [Cotylbutazone]), and sedatives (e.g., anticonvulsants, benzodiazepines, barbiturates, opiates). Similar chemical structures may cause cross-sensitivity among drugs.1,2 Drug rechallenge is the preferred method for confirming the causative drug. Patch testing and intradermal skin testing are other options.3,4

Selected Differential Diagnosis of a Penile Lesion

Condition
   

Characteristics

Syphilis
   

Single, rigid, painless, elevated ulceration with a red areola and rolled edges with a flat base

Genital herpes
   

Grouped vesicles or small ulcerations covered with serous secretion

Erythroplasia of Queyrat
   

Erythematous, moist plaque on the glans, shaft, and foreskin

Fixed drug eruption
   

Violaceous or dark erythema, may be associated with a bulla or ulceration

Chancroid (soft chancre)
   

Painful, undermined, open sore with gray-yellow, necrotic, "dirty" base; usually accompanied by inguinal adenopathy

Initial treatment involves identifying and discontinuing the culprit drug. Systemic antihistamines with topical corticosteroids can be used to treat the lesions; however, extensive lesions with bullae often require treatment with systemic corticosteroids. Eroded lesions should be observed for bacterial superinfection.3

Syphilis causes genital ulceration (chancre). However, syphilitic chancres are painless and indurated.

Genital herpes has a prodrome of pain, itching, or other dysesthesia before lesions erupt. Lesions usually are clustered in one area and are composed of many tiny vesicles or ulcers without pigmentation.

Erythroplasia of Queyrat is squamous cell carcinoma in situ of the oral or genital mucosa. The glans penis often is involved. However, it is a moist, raised, erythematous plaque rather than an ulcer.

Chancroid, which is caused by Haemophilus ducreyi, is characterized by deep, painful ulcers and tender, enlarged, and sometimes suppurative regional lymphadenopathy.

nadir goksugur, m.d.

ali haydar parlak, m.d.

Izzet Baysal University
Bolu, Turkey

references

1. Crowson AN, Brown TJ, Magro CM. Progress in the understanding of the pathology and pathogenesis of cutaneous drug eruptions: implications for management. Am J Clin Dermatol 2003;4:407-28.

2. Mahboob A, Haroon TS. Drugs causing fixed eruptions: a study of 450 cases. Int J Dermatol 1998;37:833-8.

3. Lee AY. Fixed drug eruptions. Incidence, recognition, and avoidance. Am J Clin Dermatol 2000;1:277-85.

4. Ozkaya-Bayazit E. Specific site involvement in fixed drug eruption. J Am Acad Dermatol 2003;49:1003-7.

The editors of AFP welcome submission of photographs and material for the Photo Quiz department. Contributing editor is Charles Carter, M.D. Send photograph and discussion to Monica Preboth, AFP Editorial, 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2672 (e-mail: mpreboth@aafp.org).

Copyright © 2006 by the American Academy of Family Physicians.
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[BloodyCheery]

 

[salutations]

NOBODY LIKES THAT SASSHOLE

sasshole

[shura]

that pic is great haha
welcome to the boards, i love your stuff

[Lalios]

Oh wow, It's really you . Something tells me you're gonna fit in perfect here.

PERFECT.

[bcube]

Hello and welcome

[tmk]

hi emily youcis