Case History –A Painful Toe

A 21 year old man was complaining of pain in a toe with swelling, which was interfering with his walking. The lesion was itchy and nodular. He thought he had been bitten and the insect had left a bump and black mark on the skin. Over a few days, the lesion had shrunk in size, turned brown, and wrinkled. He had recently returned from a Caribbean holiday and had been swimming and walking bare foot on the sands.