A case of warts in toe webs due to HPV type 7: Case report and literature review

“Butcher's warts” are skin lesions caused by human papillomavirus type 7 (HPV type 7). Another clinically distinctive lesion, “warts in toe webs” (WTW), localized between the toes, has also been reported but remains poorly understood. We report the case of an 84-year-old man with a refractory, cauliflower-like lesion between his toes which was unresponsive to yokuinin and liquid nitrogen cryotherapy. The patient had no history of meat of fish handling. Biopsy revealed papillary thickening of the stratum corneum and vacuolated cells. Polymerase chain reaction and immunohistochemistry analysis confirmed HPV type 7. Treatment modifications, including maintaining a dry interdigital environment, led to resolution within 2 months. Our review of 19 previously reported WTW cases indicates a distinct clinical profile: all cases involved males from Asia, with a prevalence of fungal coinfection. This case indicates the importance of HPV typing for diagnosis and maintaining a dry interdigital environment to enhance treatment outcomes.