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William Fangman, MD; Claude Burton, MD
Duke University Medical Center, Durham, NC

Arch Dermatol. 2005;141:658.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The lesions shown are from the plantar surface of a foot of a 41-year-old white man (Figure 1) and a foot of a 48-year-old white man (Figure 2). Each photograph represents a case of gram-negative toe web infection that was resistant to several courses of antibiotics, antifungal agents, and immunosuppressants, alone or in combination. With continued disease, development of a hyperkeratotic rim was noted in these 2 cases as well as in other cases seen at our institution. This hyperkeratotic rim pattern seems to be characteristic of toe web infections that are resistant to standard medical intervention. In our experience, surgical debridement of the hyperkeratotic rim and surface exudate with a standard curette with the patient under local anesthesia leads to rapid improvement (Figure 3) with routine wound care and without further medical therapy. The hyperkeratotic rim pattern . . . [Full Text of this Article]

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