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J Dtsch Dermatol Ges 2021 06 4;19(6):815-825. Epub 2021 May 4.

Charité Centrum 1 for Human and Health Sciences, Charité -University Hospital Berlin, Germany.

Wund-D.A.CH. Read More

Dermatology 2021 26;237(6):902-906. Epub 2020 Oct 26.

Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.

Introduction: Toe web infection (TWI) is a bacterial infection of the interdigital space. In most cases, the infection is caused by gram-negative bacteria, secondary to a chronic fungal infection (dermatophytosis). The typical presentation includes macerations and erosions in the interdigital space. Read More

Acta Derm Venereol 2019 10 30;99(12):1070. Epub 2019 Oct 30.

Acta Derm Venereol 2019 Nov;99(12):1121-1126

Department of Dermatology, Bordeaux University Hospital, 33000 Bordeaux, France.

Gram-negative toe-web infection can cause pain and disability, be complicated by a long healing time, management failure, and cellulitis, and recur due to persistent predisposing factors. To describe the clinical features and management of Gram-negative toe-web infection and evaluate predisposing factors and associated diseases, their management, and the effect of controlling them on the rate of recurrence, we conducted a retrospective real-life study of patients with Gram-negative toe-web infection. Among the 62 patients (sex ratio 9:1), 31 experienced more than one episode of Gram-negative toe-web infection. Read More

Dermatol Ther 2019 05 17;32(3):e12883. Epub 2019 Apr 17.

Department of Dermatology, "Emek" medical center, Afula, Israel.

Gram-negative bacterial toe web infection (GNBTWI) caused by Pseudomonas Aeruginosa combined with fungal infection has variety of treatments. However, these treatments have been poorly described in the literature. Our retrospective study describes patients that had been treated in our medical center with acetic acid combined with local antifungal treatment, to evaluate evidences for the appropriateness of this treatment. Read More

J Eur Acad Dermatol Venereol 2018 Jan 7;32(1):39-47. Epub 2017 Nov 7.

Department of Dermatology, University Hospital Jena, Jena, Germany.

Gram-negative bacterial toe web infection (GNBTWI) is a frequent therapeutic challenge in clinical practice with high recurrence rates and frequent need of systemic drugs. The aim of this systematic review was to provide an updated overview and evidence-based data on pathogens, risk factors and treatment of GNBTWI along with promoting a consistent international terminology. This systematic review is based on a search in PubMed database for English and German articles published between 1980 and 2016. Read More

W V Med J 2013 Nov-Dec;109(6):8-9

West Virginia University, Dept. of Med., Dermatology Section, P.O. Box 9158, Morgantown, WV 26506-9158, USA.

Gram-negative bacterial toe-web infections (GNBTWI's) are relatively under-recognized among physicians. Even though skin infections are usually thought to involve gram-positive bacteria, gram-negative organisms have a particular affinity for the toe-web. We present two patients with GNBTWI's who presented with maceration of the toe-webs, vesiculopustules and a hyperkeratotic rim. Read More

J Med Assoc Thai 2008 Apr;91(4):479-84

Division of Dermatology Department of Internal Medicine, Ramathibodi Hospital, Mahidol University Bangkok, Thailand.

Background: Floods are natural disasters that occur occasionally in Thailand. The most common form skin diseases due to floods are infectious dermatoses especially superficial fungal infection. However the microbiologic evidences have not been evaluated. Read More

J Am Podiatr Med Assoc 2008 Jan-Feb;98(1):42-4

Department of Dermatology, Afyon Kocatepe University, School of Medicine, Afyon, Turkey.

Background: Foot intertrigo, occurring in the interdigital space, is mostly caused initially by dermatophytes and yeasts and less frequently by gram-negative and gram-positive bacteria. With time, a "complex" may develop in the setting of moisture and maceration that contains multiple fungal and bacterial organisms.

Methods: We examined and sampled 84 patients with toe web intertrigo for bacteriologic and mycologic studies. Read More

Arch Dermatol 2005 May;141(5):658

Duke University Medical Center, Durham, NC, USA.

J Am Acad Dermatol 2001 Oct;45(4):537-41

Dermatology Department, Cagliari University Hospital San Giovanni di Dio, Cagliari, Italy.

Background: Foot intertrigo is mostly caused by dermatophytes and yeasts, less frequently by gram-positive and gram-negative bacteria. Nevertheless, the importance of polymicrobial infections and especially colonizations of Pseudomonas aeruginosa can cause therapy problems in relation to antibiotic resistance and the risk of potentially lethal complications.

Objective: The aim of this study was to evaluate the main epidemiologic and clinical features of intertrigo from gram-negative bacteria, the function of promoting factors, and the measures taken to treat and prevent this disorder. Read More

Clin Podiatr Med Surg 1996 Oct;13(4):759-66

Department of Orthopedics, University of Texas, Health Science Center at San Antonio, USA.

Cellulitis occurring in the lower extremity is encountered frequently and results from a breach of the skin and inoculation of opportunistic bacteria. It has been shown that when web space dermatophytosis is present, changes may occur in normal skin morphology and bacterial flora that can result in severe infection. Knowledge of the pathophysiology of interdigital dermatophytosis allows the clinician to choose the most appropriate empiric antibiotic therapy when treating a secondarily caused cellulitis of the lower extremity. Read More

J Am Acad Dermatol 1990 Apr;22(4):583-6

Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia.

Twenty-four patients with severe interdigital toe web infections and no evidence of dermatophyte colonization received randomized treatment with either econazole nitrate (Spectazole) or its vehicle. Of the patients treated with econazole nitrate, 88% had good to excellent responses, whereas no patient treated with the vehicle showed improvement. The total aerobic flora in the econazole group decreased 93%, with decreases in the large-colony diphtheroids, lipophilic diphtheroids, and gram-negative bacteria. Read More

J Med Assoc Thai 1989 Jul;72 Suppl 2:33-8

Bacterial colonization was studied in 12 non-infected female patients admitted into one medical ward, Siriraj hospital, Bangkok, from March to June 1988. Swabs were taken on the first day of admission, then every other day until discharge, from six sites; i.e. Read More

Z Hautkr 1988 Nov;63(11):958-65

Zentrum für Dermatologie, Andrologie und Venerologie, Abt. klin. u. exp. Dermatologie, Justus-Liebig-Universität Giessen.

Referring to recent studies, we discuss the epidemiology of tinea pedis and its position within the range of polyetiological foot infections caused by microbial agents. 201 industrial workers used to wear rubber boots because of moist working conditions were examined with regard to their feet. 107 of them showed clinically altered toe web; in 45 cases, we found ringworm infection (22. Read More

J Am Acad Dermatol 1986 Feb;14(2 Pt 1):278-9

J Am Acad Dermatol 1983 Feb;8(2):225-8

Fifteen patients with gram-negative bacterial toe web infections were treated for 1 week with intramuscular cefoperazone, a broad-spectrum third generation cephalosporin. Initial bacterial cultures in eleven patients (73%) grew more than one gram-negative organism. Pseudomonas aeruginosa was the most frequent isolate. Read More