Chronic interdigital dermatophytic infection: A common lesion associated with potentially severe consequences

• Published in: Diabetes research and clinical practice 2011-01, Vol.91 (1), p.23-25
• Main Authors: Vanhooteghem, Olivier, Szepetiuk, Gregory, Paurobally, Dilshad, Heureux, Françoise
• Format: Article
• Language: English
• Subjects: Abscess - complications; Abscess - diagnostic imaging; Abscess - microbiology; Abscess formation; Anti-Bacterial Agents - therapeutic use; Diabetic Foot - complications; Diabetic Foot - microbiology; Endocrinology & Metabolism; Erysipelas - complications; Erysipelas - drug therapy; Erysipelas - microbiology; Humans; Interdigital intertrigo; Intertrigo - complications; Leg erysipelas; Onychomycosis; Secondary bacterial infections; Skin complications; Streptococcus pyogenes - isolation & purification; Tinea pedis; Toes - diagnostic imaging; Treatment Outcome; Ultrasonography
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2010.09.016

Abstract Interdigital intertrigo and onychomycosis has the potential cause of severe bacterial infectious complications with pain, mobility problems, abscess, erysipelas, cellulitis, fasciitis and osteomyelitis. In another hand, diabetic neuropathy, which affects 60–70% of those with diabetes mellitus, is one of the most troubling complications for persons with diabetes. These people are high suspecting to be infected by dermatophytic infections in interdigital spaces or onychomycosis witch are frequently induce damage to the stratum corneum, leading to bacterial proliferation and secondary infection. A patient presented with an asymptomatic warm, painless, erythematous swelling of the second left toe, which had been present for a few weeks. Clinically, the lesion was categorized as erysipelas upon an insidious abscess formation. Further investigation was undertaken to confirm the presence of diabetes. Leg erysipelas is a common affection which, according to various studies, has both local concomitants (interdigital intertrigo, lymphoedema, surgical antecedents) and/or general causes (immune suppression, diabetes, alcoholism, etc). Interdigital intertrigo, tinea pedis, and onychomycosis present as public health problems that could trigger serious deterioration in patient quality of life, due to complications induced by secondary bacterial infections.