Interdigital Web Space Research Articles

BACTERIOLOGICAL AND MYCOLOGICAL PROFILE OF TOE WEB SPACE INFECTIONS: A CLINICO EPIDEMIOLOGICAL STUDY

Background: Dermatophytic fungi are more commonly associated with interdigital toe web space infections. However, the disease pertains to other pathogens also. In recent years, there has been an increasing number of reports concerning non-dermatophytic fungal infections and mixed infections with gram negative bacteria. Objectives : 1) To study the clinical prole of toe web space infections 2) To know the aetiology of toe web space infections Materials and Methods : 50 clinically suspected adult cases (18-60 years) of toe web space infections were included in the study. Detailed history was taken and clinical examination was performed. Specimen samples were collected from toe web space and Gram staining, KOH mount, bacterial and fungal culture were done. Majority of study subjects belonged to 40-60 yea Results: rs age group with no gender difference. Housewives by occupation constituted for 34% of study subjects. Diabetes can be considered as an important risk factor in the etiology (21%). 85% participants presented with maceration, 70% with scaling, 65% with erythema, 35% with pruritus. 4th toe web space was commonly involved (40%). Tinea pedis, psoriasis and cellulitis are most commonly associated cutaneous diseases among the study participants. Among the fungal species isolated, candida (39%) fusarium (34%) and trichophyton (30%) were the common ones Staphylococcus aureus (35%) klebsiella (16%) pseudomonas (12%) were the common bacterial organisms isolated. Conclusion: Fourth toe web space infection was most commonly noted and majority of study subjects belonged to 40-60 years age group, among whom housewives were predominantly affected. Candida, Fusarium, Trichophyton, Staphylococcus aureus, Klebsiella and Pseudomonas were the most common species isolated. There are many etiological factors responsible for toe web space infections, which are usually over diagnosed, underdiagnosed/ misdiagnosed. Hence proper clinical approach and laboratory investigations would yield denitive diagnosis resulting in appropriate treatment.

The Sandwich Technique for Quick and Efficient Application of Negative Pressure Wound Therapy to the Feet and Hands: A Case Report

Introduction. NPWT is a surgical dressing that combines polyurethane foam with the subsequent application of continuous or intermittent negative pressure. NPWT facilitates granulation tissue production by macrostrain, microstrain and, if desired, fluid instillation. Sealing the polyurethane foam over the wound bed is achieved using acrylic drapes; however, this can be difficult to use in some anatomic sites. Failure to achieve an effective seal can necessitate additional supplies, which has led to increased innovation in developing a more effective NPWT seal over the target wound bed. Obtaining an effective pressure seal on the feet or hands can be difficult because these anatomic sites have distinct curvature for each digit, with multiple interdigital web spaces and independent mobility. In this case report, the authors propose a technique to apply either an acrylic drape or combination acrylic and soft silicone drape utilizing the “sandwich technique” to seal NPWT foam quickly and efficiently to the feet or hands.

Mono-helix bandage using cotton gauze strip as an easy and inexpensive method for separating interdigital toe web space

Mono-helix bandage using cotton gauze strip as an easy and inexpensive method for separating interdigital toe web space

An innovative technique for the separation of toes to prevent and treat intertrigo of toe web space

Interdigital dermatoses can usually be treated by keeping the interdigital web space dry and clean. The web space can be kept dry by keeping the toes separated. Unfortunately, this is difficult in patients having arthritis, obesity, diabetes, etc. A number of techniques have been suggested by different authors to keep toes separated using coiled wire loop,1 a thermocol spacer, etc. Apart from these, many toe separators are available online and can even be customized.2 However, they are not easily available, are often costly, and may not be comfortable to use.

The Effect of Systemic Antibiotics for Suppurative Skin and Soft Tissue Infections on the Skin Microbiome.

BackgroundSkin and soft tissue infections (SSTIs) are very common bacterial infections. There are few data on the microbiome of persons with and without SSTIs and the effects of systemic antibiotic therapy.MethodsWe sampled the skin microbiome from 10 outpatients with acute suppurative SSTI before and after systemic antibiotic therapy and enrolled 10 matched controls. Samples were collected at 6 skin body sites (occipital scalp, axilla, interdigital hand web spaces, gluteal crease, inguinal creases, and popliteal fossa), 2 mucosal sites (throat, anterior nares), and the site of skin infection (for case subjects) at baseline and a week later after abscess incision, drainage, and oral antibiotics.ResultAmong 10 SSTI cases, mean age was 41.5 years and 3 had diabetes mellitus. The gluteal crease at baseline had higher α-diversity in controls vs cases (P = .039); β-diversity analysis showed significant differences in overall bacterial community composition (P = .046). However, at other body sites there were no significant differences by either α- or β-diversity. Systemic antibiotic use did not affect body site diversity indices except at the SSTI site (α-diversity increased, P = .001).ConclusionsWe surprisingly found no significant differences in microbiome comparing noninfected skin sites before and after systemic SSTI antibiotic therapy nor significant differences at noninfected skin sites between SSTI cases and uninfected controls. We also found minimal significant differences between microbiome diversity and bacterial signatures at noninfected skin sites between patients with acute skin infection and uninfected controls. Our findings challenge the dogma that systemic antibiotics impact the skin microbiome.

Utility of Axillary Reverse Mapping (ARM) and Incidence of Metastasis in Arm Draining Lymph Nodes in Patients with Breast Cancer.

Objective Lymphedema of the upper limb is the most common complication in patients with breast cancer, who require axillary lymph node (LN) dissection. Proposition of identifying upper limb draining LN and preserving it, during axillary dissection can reduce significant postoperative morbidity, but it has the risk of inadequate oncological resection. This study was planned to find out metastatic rate in axillary reverse mapping (ARM) nodes in our population. Materials and Methods Lymphoscintigraphy (LSG) was performed using intradermal injection of 99m Tc Sulfur Colloid into ipsilateral second and third interdigital web spaces of hand in patients with breast cancer. Planar, single-photon emission computed tomography-computed tomography images were acquired followed by intraoperative localization of arm draining LNs using Gamma Probe. All identified ARM nodes were dissected and sent for histopathological examination to confirm metastatic involvement. Results Twenty eligible patients were prospectively analyzed. The identification rate of arm draining LN with LSG was 90% (18/20). Among 14 eligible patients included in the study, ARM node metastasis was seen in two patients. A total of 64 ARM nodes were dissected from 14 patients, 4/64 nodes (2 patients) were positive for metastases (6.25%). Of the six patients excluded from the study, in 1 patient ARM node could not be identified on Gamma Probe, in two cases, it could not be retrieved surgically, in next two cases ARM could not be identified on LSG and remaining one case was removed because of previous surgical intervention. Conclusion In the current study, LSG showed the identification rate of 90% for ARM nodes in patients with carcinoma breast and metastatic involvement was seen in 6.25% (4/64) of these nodes in 2/14 (14.2%) patients, which is in agreement with previously published data. Oncological safety of preserving ARM nodes needs to be evaluated in the larger population.

Scabies involving palms in older children and adults: a changing scenario.

Scabies is a highly contagious, intensely pruritic skin infestation caused by Sarcoptes scabiei var hominis. It has high prevalence in many tropical countries where crowded people live in resource-poor settings. The rash is distributed differently in adults and children. Adults manifest lesions primarily on the interdigital web spaces of the hands, flexor aspects of the wrists, dorsal feet, axillae, elbows, waist, buttocks, and genitalia. Palms (along with soles and head) are commonly involved in infants and very young children but typically absent in older age groups. Here, we report 25 older children and adult patients with scabies including involvement of the palms. If patients are left untreated for long periods of time in hot tropical climates, scabies may produce severe infestation with involvement of palms in older children and adults. We should acknowledge palms as potential body sites whose involvement warrants early and aggressive treatment in scabies.

Mycological profile of intertrigo of foot in a tertiary care hospital, Mysore, South India

Introduction: Intertrigo is an inflammatory condition of skin folds commonly seen in any age from infancy to old age and one of the major cause for clinical consultations. Intertrigo is due to heat, moisture or lack of air circulation and the infection is most commonly seen in patients with diabetes. Foot intertrigo is the infection of Toe web spaces occurring mainly at interdigital toe web spaces. The friction of skin folds may lead to several complications which includes bacterial or fungal infections. Materials and Methods: A total of 75 clinically suspected cases of foot intertrigo were included in the study. Skin scrapings from the suspected cases of intertrigo were collected with standard precautions and all the samples were subjected to direct microscopy using 10% Potassium hydroxide and observed for presence of fungal elements and simultaneously the sample is processed for culture onto fungal culture media to identify the causative agents of foot intertrigo. Results: A total of 75 skin scrapings from the infected foot for Mycological study were collected among which 38 samples were collected from male patients and 37 samples were from female patients. Of 75 skin scrapings, 31 were 10% KOH positive and remaining 44 were negative to microscopy. On culture 34 samples were culture positive and 41 were culture negative. Out of 34 culture positive samples, Candida albicans were isolated in 15 specimens and Non-candida albicans in 6. Remaining samples yielded growth of moulds in which Dermatophytes (Trichophyton-3, Epidermophyton-1) were 4 isolates and Fusarium yielded growth in 9 samples. Conclusion: From our study, we conclude that intertrigo is a chronic inflammation. This might occur at any age. In our descriptive study, Candida albicans were predominantly isolated followed by other moulds such as Fusarium and Dermatophytes. Keywords: Intertrigo, Candida albicans, Fusarium, Dermatophytes.

Barber’s Abscess: Pilonidal Sinus in a Female Barber’s Hand

Barber’s abscess is an acquired occupational disease, thought to be caused by short hair clippings that enter the susceptible web space skin, usually seen in male barbers. This case report is to report a rare case of a female barber, who developed a pilonidal sinus (PS) in the interdigital web space of her non-dominant left hand, requiring excision with a flap reconstruction and also to review the relevant literature. A 46-year-old female barber underwent day case surgical excision of the PS with a Foucher flap reconstruction of her left non-dominant hand, third web space. The patient remains disease-free 3 years on. PS of the interdigital space of the hand is a rare and preventable acquired occupational disease. Personal hygiene and meticulous removal of any hair clippings from the web space could prevent the formation of the pilonidal sinus.

Non-surgical treatments for Morton’s neuroma: A systematic review

TitleNon-surgical treatment for Morton’s neuroma: a systematic review. BackgroundMorton’s neuroma (MN) is an entrapment degenerative neuropathy with a strong predilection for the 3rd interdigital web space. The objective of our study was to identify the most significant evidence produced for the non-operative treatment of Morton's neuroma and assess outcomes of these interventions. MethodThe electronic databases Medline, Ovid EMBASE, CINAHL and Cochrane CENTRAL from inception to October 2018 were searched. Two independent reviewers assessed the quality of the studies using the Modified Coleman Criteria. Statistics were combined across cohort studies to calculate pooled mean results, and improvements in outcomes. ResultsInitial electronic and hand search identified 486 studies. After title and abstract review there were 38 that went on to full-text review. Finally, 22 studies were included in the final review. We identified 9 different non-operative treatment modalities; Corticosteroid injection, Alcohol injection, Extra-corporeal Shockwave therapy (ESWT), Radiofrequency Ablation (RFA), Cryoablation, Capsaicin injection, Botulinum toxin, Orthosis and YAG Laser Therapy. Corticosteroid showed a statistically significant reduction in mean VAS over all their studies (p < 0.01), with 50% success at 12 months. Alcohol showed promising short-term pain-relieving results only. Orthotics, Capsaicin injections, Cryoablation, Botulinum toxin, RFA and ESWT did show statistically significant improvements, but with limitation to their application. ConclusionFollowing review, the authors would recommend the use of corticosteroid injections to treat Morton’s neuromas. The authors feel that radio-frequency ablation and cryoablation would benefit from further well designed randomised controlled trials.

Treatment of postoperative high-volume lymphatic complications using isosulfan blue

BackgroundLymphocele (LC) and lymphocutaneous fistula (LF) are infrequent but serious complications that occur when lymphatics are disrupted during a vascular procedure. Conservative management with bed rest, extremity elevation, aspiration, and pressure dressing is often ineffective. This study evaluated the effectiveness of isosulfan blue (ISB) to identify disrupted lymphatics for ligation. MethodsBetween 1998 and 2016, there were 33 lymphatic complications treated with ISB-directed ligation in 32 patients. The patients' records were retrospectively reviewed, recording demographics, comorbid conditions, index vascular operation causing the lymphatic complication, details of the procedure done to treat the lymphatic complication, and outcomes. In each patient, between 1 and 3 mL of ISB was injected in the subcutaneous tissue of the interdigital web space. The wound associated with the lymphatic complication was opened. The appearance of dye within the wound identified disrupted lymphatic ducts for suture ligation. ResultsThe lymphatic complications were either LC (11 [33%]) or LF (22 [66%]) and were associated with femoral vein harvest (9), great saphenous vein harvest (8), exposure of femoral arteries (13), creation of an upper extremity fistula (1), repeated femoral access for coronary angiography, or excision of an LC (1). Most patients were male (66%), and the mean age was 56.8 ± 13.1 years. In comparing patients with LF and LC, the diagnosis of LF was made earlier (13.8 ± 7.0 days vs 23.4 ± 14.1 days; P = .02), and treatment occurred sooner for LF than for LC (22.1 ± 8.1 days vs 48.8 ± 51.2 days; P = .02). In all patients, ISB identified one or more disrupted lymphatics. The appearance of the ISB dye within the wound after injection was rapid, often within 5 to 10 minutes. After ligation of the lymphatics, most wounds were closed primarily (26 [79%]), but a muscle flap (5 [15%]), negative pressure dressing (1 [3%]), and dressing changes (1 [3%]) were also used. Wound healing was achieved in all patients on average 32.5 ± 21.5 days after lymphatic ligation. ConclusionsThe current series is one of the largest reported experiences using ISB to identify injured lymphatics responsible for LC or LF. Lymphatic complications after a vascular procedure usually occur within 3 weeks of the index vascular procedure, with LF being identified and treated earlier than LC. ISB injection rapidly identifies disrupted extremity lymphatics. Ligation of these lymphatics results in reliable resolution of the lymphatic complication.

Prevalence and Clinical Correlation of Superficial Fungal Foot Infection in Thai Naval Rating Cadets.

Superficial fungal foot infection is one of the most important dermatological diseases currently affecting military personnel. Many Thai naval rating cadets are found to suffer from superficial fungal foot infections and their sequels. To investigate prevalence, potent risk factors, responding pathogens and clinical correlation of superficial fungal foot infection in Thai naval rating cadets training in Naval rating school, Sattahip, Thailand. This cross-sectional study was performed in August 2015. Validated structured questionnaire was used regarding information about behaviors and clinical symptoms. Quality of life was assessed by Dermatology Quality of Life Index (DLQI) questionnaire and clinical presentation demonstrated by Athlete's foot severity score (AFSS). Laboratory investigations including direct microscopic examination and fungal culture were performed and recorded. All of the participants were informed and asked for their consent. A total of 788 Thai naval rating cadets with a mean age of 19 yr were enrolled. There were 406 (51.5%) participants suspected of fungal skin infection from questionnaire screening. After clinical examination, 303 participants (38.5%) were found to have foot lesions (AFSS ≥1). Superficial fungal foot infection was diagnosed with microscopic examination and fungal culture in 57 participants, giving a point prevalence of 7.2%. Tinea pedis was diagnosed in 54 participants with the leading causative organism being Trichophyton mentagrophytes (52.8%). Other 3 participants were diagnosed as cutaneous candidiasis. Wearing combat shoes more than 8 h was found to be a predisposing factor (p = 0.029), taking a shower less than two times a day (p = 0.008), and wearing sandals during shower (p = 0.055) was found to be protective against infection. Most fungal feet infection cases noticed their feet abnormalities (p < 0.001) including scales (p < 0.001), vesicles (p = 0.003) and maceration at interdigital web spaces (p < 0.001). Mean DLQI in superficial fungal foot infection cases was 3.35. Participants who had foot lesions (AFSS ≥1) were concerned of their foots unpleasant odor demonstrated significantly higher mean DLQI than those without odor (4.2 vs. 2.28; p < 0.001). Superficial fungal foot infection is found as 7.2% of naval rating cadets. Wearing combat shoes more than 8 h was found to be a predisposing factor. In addition to skin manifestations including scales, vesicles, and maceration, superficial fungal foot infection also exhibited an unpleasant foot odor which affected quality of life. Self-foot-examination and life style modification should be promoted to prevent fungal infection.

Scabies presenting as cutaneous nodules or malar erythema: reports of patients with scabies surrepticius masquerading as prurigo nodularis or systemic lupus erythematosus

Scabies surrepticius is a unifying term that represents non-classical presentations of scabies mite infestation. A patient with scabies surrepticius is described: a man with scabies masquerading as prurigo nodularis. The 91-year-old man had metastatic prostate cancer and presented with diffuse pruritic nodules. Prurigo nodularis was suspected; however, the biopsy revealed scabies mites in the stratum corneum. He was successfully treated with topical permethrin 5% cream and oral ivermectin. In addition, the features of a woman with scabies mimicking systemic lupus erythematosus are summarized. The 47-year-old woman had idiopathic thrombocytopenic purpura and presented with malar erythema and a positive antinuclear antibody (titer 1:320). A diagnosis of systemic lupus erythematous was entertained until skin scraping and mineral oil preparation revealed scabies mites; she was successfully treated with oral ivermectin. In conclusion, Sarcoptes scabiei infestation can present with atypical clinical morphology and an absence of classical lesions such as burrows conventionally distributed in the interdigital web spaces, volar wrists, periumbilical area, or genitalia. Scabies surrepticius is a term that has been designated to describe these unusual presentations. Prurigo nodularis and systemic lupus erythematosus can be added to the litany of conditions masquerading as scabies and are included amongst the guises of scabies surrepticius.

Erosio interdigitalis blastomycetica: A review of interdigital candidiasis

Erosio interdigitalis blastomycetica (EIB) is a Candida infection affecting the third web space, between the third and fourth fingers. In 1915, Gougerot and Goncea first described saccharomycetic organisms isolated from the hands and feet. Johannes Fabry later named it in 1917, well before the genus Candida was introduced in 1923. EIB is most common among those who work with their hands frequently in water, such as dishwashers, launderers, bartenders, and homemakers. Clinical presentation most commonly consists of a central erythematous erosion surrounded by a rim of white macerated skin involving at least one interdigital web space. The differential diagnosis is narrow, consisting of irritant contact dermatitis (ICD), erythrasma, inverse psoriasis, and bacterial infection (i.e. impetigo). The diagnosis is made by clinical examination in addition to fungal culture and KOH testing. The prognosis is good and treatment options include avoidance of frequent water immersion and topical or oral antifungal agents. Suspicion for secondary infections such as erysipelas and cellulitis should remain high until lesions have resolved. This review aims to address the history, epidemiology, pathophysiology, histopathology, clinical presentation, differential diagnoses, diagnosis, prognosis, and management of EIB. It also suggests an alternative name in place of the current misnomer.

Topographical diversity of common skin microflora and its association with skin environment type: An observational study in Chinese women

This study evaluated cutaneous microbial distribution, and microbial co-occurrence at different body sites and skin environments in Chinese women (39.6 ± 11.9 years, N = 100) during the winter season. Microbial distribution (Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis, Lactobacillus, Pseudomonadaceae, and Malassezia furfur), association with biomarkers (antimicrobial peptides: LL-37, β-defensins [HBD-2, HBD-3]), and claudin-1) and skin biophysical parameters (transepidermal water loss, pH, skin scaliness and roughness, sebum and hydration levels) were also determined. Skin sites (glabella [GL], hand-back [HB], interdigital web-space [IS], antecubital fossa [AF], volar forearm [VF], back [BA]) were classified as normal, oily or dry based on two-step cluster analysis and exposed or unexposed (uncovered or covered by clothes, respectively) based on seasonal apparel. Pseudomonadaceae and Staphylococcus aureus had the highest and lowest detection rate respectively at all sites. Cluster analysis identified skin sites as ‘normal’ (HB, BA, AF, VF), ‘dry’ (IS) and ‘oily’ (GL). Bacterial alpha diversity was higher in exposed (HB, IS, and GL) compared with unexposed sites (BA, AF and VF). Co-occurrence of Staphylococcus aureus with any of the other five microorganisms was lower in dry and oily skin versus normal skin. Skin exposure, biophysical/barrier profile and biomarkers were found to be associated with bacterial distribution and co-occurrence.

The epidemiology of Staphylococcus aureus carriage in patients attending inner city sexually transmitted infections and community clinics in Calgary, Canada.

BackgroundAlthough the nares represent the most common carriage site for traditional hospital-associated strains of Staphylococcus aureus (SA), the predominant site of carriage of SA in the community is less certain.MethodsWe conducted a cross-sectional study in 285 patients attending sexually transmitted diseases and inner-city clinics to evaluate the prevalence, body site colonisation and risk factors associated with carriage of methicillin susceptible SA (MSSA). All isolates were characterized by pulsed field gel electrophoresis, staphylococcal cassette chromosome mec, staphylococcal protein A and multilocus sequence typing.ResultsThe prevalence of colonisation with SA was 57.5% (164/285); 162 (56.8%) participants were colonized with MSSA, and 4 (1.4%) with methicillin-resistant SA (MRSA), 2 of them were co-colonised with both MRSA and MSSA. The most common sites of colonisation were the throat (73.1%), nares (65.2%) and interdigital web spaces of the hand (21.3%). Three out of 4 MRSA isolates were USA300-MRSA strains. Twelve MSSA isolates were closely related to the USA300 CA-MRSA. We identified sexual behaviours such as having more than 6 heterosexual sexual partners in the last 6 months and trimming pubic hair to be independently associated with MSSA colonisation, and more specifically practicing oral sex as a risk factor for throat colonisation.ConclusionThere is a high prevalence of MSSA carriage in this population, with a low prevalence of MRSA. The throat was the most common site of carriage and sexual behaviours were found to be risk factors for MSSA colonisation. Close strain relatedness of MSSA and USA300-MRSA isolates suggests either gain or loss of the SCCmec element, respectively.

Flexor Pollicis Longus Tendoscopy

The deep palmar spaces of the hand include the midpalmar space, the hypothenar space, the thenar space, space of Parona, and the interdigital web spaces. There are various communications between different spaces. These communications are of clinical importance in explaining the spread of inflammatory, infectious, and even neoplasic processes that involve this region. Surgical incision and drainage of all potentially communicating spaces and compartments is mandatory in deep hand infections. The purpose of this technical note is to describe the minimally invasive approach of endoscopic drainage and debridement of the flexor pollicis longus tendon sheath, radial bursa, and thenar space.

Principales parasitoses cutanées : mise au point

Cutaneous parasitic skin diseases are frequent in human pathology. There are few reliable epidemiological data on the prevalence and/or incidence of such diseases. Skin parasites are cosmopolitan but their global distribution is heterogenous; prevalence is especially high in subtropical and tropical countries. They are mainly due to arthropods (insects and mites). Many species of parasites are involved, explaining the diversity of their clinical signs. The most common are caused by ectoparasites such as scabies or pediculosis (head lice, body lice and pubic lice). Clinical signs may be related to the penetration of the parasite under the skin, its development, the inoculation of venom or allergic symptoms. Diagnosis can be easy when clinical signs are pathognomonic (e.g. burrows in the interdigital web spaces in scabies) or sometimes more difficult. Some epidemiological characteristics (diurnal or nocturnal bite, seasonality) and specific clinical presentation (single or multiple bites, linear or grouped lesions) can be a great diagnostic help. Modern non-invasive tools (dermoscopy or confocal microscopy) will play an important role in the future but the eye and experience of the specialist (dermatologist, parasitologist, infectious disease specialist or entomologist) remains for the time the best way to guide or establish a diagnosis. For most skin parasites, therapeutic proposals are rarely based on studies of high level of evidence or randomized trials but more on expert recommendations or personal experience.

Pedicled Instep Flap and Tibial Nerve Reconstruction in a Cynomolgus Monkey[Macaca fascicularis]

A male cynomolgus monkey experienced extensive soft tissue trauma to the right caudal calf area. Some weeks after complete healing of the original wounds, the monkey developed a chronic pressure sore on plantar surface of the heel of its right foot. A loss of sensitivity in the sole of the foot was hypothesized. The skin defect was closed by a medial sensate pedicled instep flap followed by counter transplantation of a full thickness graft from the interdigital webspace. The integrity of the tibial nerve was revised and reconstructed by means of the turnover flap technique. Both procedures were successful. This is an uncommon case in an exotic veterinary patient as it demonstrates a reconstructive skin flap procedure for the treatment of a chronic, denervated wound in combination with the successful reconstruction of 2.5 cm gap in the tibial nerve.

Interdigital pilonidal sinus, report of two cases

Hairdresser's disease is an occupational acquired interdigital pilonidal sinus (IPS) of especially male barbers. Here, two cases of IPSs are reported. Both cases underwent surgical excision and primary closure. Six months follow-up period did not present any complications or recurrence. Caused by repeated implantation of foreign hair to the interdigital web space, IPS is preventable, but once acquired treated with surgical excision and primary closure or with a skin flap for postoperative comfort.