Cowboy Boot Neuropathy

To the Editor.— Given the propensity ofThe Journaland its readers to present new and interesting causes and forms of peripheral neuropathy, such as with flautists, "Space Invaders" players, and so forth, I thought the following case might be of interest as well. Report of a Case.— A 53-year-old man came to my office complaining of one week of numbness and tingling in the tips of all ten toes, gradually worsening. There were no color changes, and there was no history of trauma. He took no medications. He had no symptoms in his hands and no other neurological symptoms. He used no tobacco products. Physical examination results were essentially unremarkable, including light touch and pinprick of the toe tips. Routine laboratory study findings were normal. The only possible precipitating factor that could be implicated was that he wore cowboy boots to work a lot in his job as a