PMC10202823_01
Interdigital lesions at the patient's first visit.
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Physical examination revealed several well-defined, reddish-brown, flat-topped, odorless plaques with smooth surfaces located in the interdigital web space between the second and third toes of the left foot (Figure 1).
The epidermis contained marked regular elongation of the rete ridges, parakeratosis, and acanthosis (original magnification 40x).
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Histopathology of the lesion revealed parakeratosis, abundant neutrophilic infiltration with acanthosis, and regular elongation of the rete ridges within the epidermis (Figures 2 and 3).
Evident neutrophilic infiltration in the epidermis layer and dermal inflammation with plasma cell predominance accompanied by swelling of endothelial cells of the small blood vessels (original magnification 200x).
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Histopathology of the lesion revealed parakeratosis, abundant neutrophilic infiltration with acanthosis, and regular elongation of the rete ridges within the epidermis (Figures 2 and 3). Dense infiltration of plasma cells was observed throughout the dermal layer (Figure 3).
Innumerable spirochetes within the epidermis and scattered spirochetes within the dermis detected by immunohistochemistry (original magnification 100x).
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Immunohistochemistry revealed numerous spirochetes within the epidermis (Figure 4).
Interdigital lesions completely resolved 1 month after treatment.
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One month after treatment, the skin lesion had entirely resolved, and only hyperpigmentation was observed (Figure 5).