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To the Editor:—
Dr Grayson's point is well taken. However, fungus infection is by no means the only cause of interdigital maceration and fissuring; we have known for many years that pathogenic fungi can be cultured in only a certain percentage of these patients. Sarkany, Zaplin, and Blank at the University of Miami have reported (JAMA177: 130-132 [July 15] 1961) that a significant number of these patients with involvement of the third and fourth interdigital spaces of the feet have erythrasma. Also, patients with chronic recurrent eczematous dermatitis on various sites of the feet, but particularly the dorsum of the toes and the upper pole of the interdigital spaces, may have an associated recurrent cellulitis.
Livingood CS. Recurrent Erysipelas and Epidermophytosis Pedis. JAMA. 1964;189(3):241. doi:10.1001/jama.1964.03070030063027
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