"Athlete's foot" infection or tinea pedis is a common infection of civilized man. Most cases respond to conservative local antifungal preparations or to systemic griseofulvin. Disability may be significant because of secondary bacterial or yeast infections. Congenital orthopedic anomalies which prevent adequate aeration of toe webs may be a contributing factor in cases refractory to routine conservative management.
Two cases of severe chronic tinea pedis unresponsive to local and systemic medications are presented. In one, amputation of the fifth toe and syndactylization of the fourth and third toes prevented further loss of employment. In the second, disarticulation of all toes, except the great toes, was performed. As drastic as this procedure might appear, the disability therefrom is far less than that of a severe, unremitting fungal and bacterial infection.
Syndactylization or amputation of the toes should be reserved for the rare, severe, and incapacitating fungal infections of the feet that do not respond to all other modalities of therapy.
Goldstein N, Woodard GS. Surgery for Tinea PedisSyndactylization or Amputation of Toes for Chronic, Severe Fungus Infections. Arch Dermatol. 1969;99(6):701-704. doi:10.1001/archderm.1969.01610240059010