Study of the Etiological Causes of Toe Web Space Lesions in Cairo, Egypt

Abstract

Background. The etiology of foot intertrigo is varied. Several pathogens and skin conditions might play a role in toe web space lesions. Objective. To identify the possible etiological causes of toe web space lesions. Methods. 100 Egyptian patients were enrolled in this study (72 females and 28 males). Their ages ranged from 18 to 79 years. For every patient, detailed history taking, general and skin examinations, and investigations including Wood's light examination, skin scraping for potassium hydroxide test, skin swabs for bacterial isolation, and skin biopsy all were done. Results. Among the 100 patients, positive Wood's light fluorescence was observed in 24 and positive bacterial growth was observed in 85. With skin biopsy, 52 patients showed features characteristic for eczema, 25 showed features characteristic for fungus, 19 showed features characteristic for callosity, and 3 showed features characteristic for wart while in only 1 patient the features were characteristic for lichen planus. Conclusion. Toe web space lesions are caused by different etiological factors. The most common was interdigital eczema (52%) followed by fungal infection (25%). We suggest that patients who do not respond to antifungals should be reexamined for another primary or secondary dermatologic condition that may resemble interdigital fungal infection.

Pityriasis versicolor profiles among outpatients of the Dermatology Department of the Teaching Hospital of Yopougon Abidjan, Cote dIvoire

“…A diagnosis of PV can be confirmed by microscopy using skin scrapings from theborders of lesions in a KOH mount or by obtaining samples using the cellophane tape method (Gupta and Foley, 2015), as in this study. The two techniques are similarly reliable (Hassab-El-Naby et al, 2010). Mycological culture of Malassezia offers the advantage of isolating the species concerned but is a difficult technique which requires special media (Sabouraud and Dixon's media with added olive oil in both) (Sharma et al, 2016).…”

Fungal Diabetic Foot Infections

“…The specimen was collected in a sterile container, and the tissue was soaked with phosphate buffered saline 10 . The affected toenails were cleaned with 70% alcohol and nail scraping was taken with a sterile scalpel blade and collected in a clean dry paper envelope 11 . Tissue specimens were collected from the infected toe-webs 12 .…”

Toe Web Infection: Epidemiology and Risk Factors in a Large Cohort Study

“…This process may progress to advanced stages of gram-negative infection with sepsis. Lesions that affect the interdigital spaces can occasionally extend to the plantar area and the back of the toes [6,7].…”

“…Few studies have investigated risk factors for TWI, though the infection is commonly associated with both interdigital tinea pedis and the use of closed-toe or tight-fitting shoes and hyperhidrosis. It is also prevalent among individuals such as athletes and soldiers who physically exert themselves, as well as individuals who fail to maintain proper foot hygiene [3,7,9].…”