Green Foot

Abstract

Pseudomonas aeruginosa may infect the skin surface, nails, hair follicles, or deeper tissues. We report a 13-year-old male with an asymptomatic green discoloration of the toenails and sole of the right foot. Pseudomonas aeruginosa was cultured from the shoe, but not from the discolored skin. We suspect that constant wearing of occlusive, rubber-soled, basketball shoes associated with hyperhidrosis allowed colonization of his shoe with pseudomonas. This case is unique in that colonization resulted in a green color of the foot not associated with infection of the skin.

ReviewCutaneous manifestations due toPseudomonasinfection

“…This condition should not be confused with green foot syndrome described by LeFeber and Glotiz 34 in an adolescent whose toenails and sole of the foot had a greenish discoloration due to PA colonization of the rubber of his sports shoes. In these lesions, PA is not isolated, and they are the result of colonization of the footwear which diffuses the pyoverdin.…”

Infectious Pseudochromhidrosis: A Case Report and Literature Review

“…Pseudochromhidrosis is a condition where colourless, eccrine sweat becomes coloured by exogenous factors on the skin surface, such as chromogenic microorganisms (1,2,15,(36)(37)(38) and chemical agents (39)(40)(41)(42). The reported colours are yellow (5), red (43)(44)(45), pink (46,47), blue (2,37,38), green (36,48), brown (39,40), and black (44,49,50), most commonly localized on the face, neck, and palms (2). Since bacteria are potential causative agents of pseudochromhidrosis; infectious pseudochromhidrosis (IPCH) is becoming an increasingly used term in literature (1,15).…”

“…Pseudomonas aeruginosa -blue-green IPCH (36,48,62): P. aeruginosa is a Gram-negative, aerobic coccobacillus, which is widespread in nature (63). It is well known that the bacteria can colonize moist skin surfaces and can cause a greenish discolouration of skin, nails, clothes, and surgical dressings (48,62,64,65). There are also several case reports where IPCH has been suspected despite negative cultures (5,43,44,51,66).…”

“…Pseudochromhidrosis is a condition where colourless, eccrine sweat becomes coloured by exogenous factors on the skin surface, such as chromogenic microorganisms ( 1 , 2 , 15 , 36 – 38 ) and chemical agents ( 39 – 42 ). The reported colours are yellow ( 5 ), red ( 43 – 45 ), pink ( 46 , 47 ), blue ( 2 , 37 , 38 ), green ( 36 , 48 ), brown ( 39 , 40 ), and black ( 44 , 49 , 50 ), most commonly localized on the face, neck, and palms ( 2 ).…”

An unusual presentation of immersion foot

“…5 Although not an uncommon infection, we found only one other report, namely a 13 year old with green discoloration of the toenails and sole of the foot who had P aeruginosa cultured from his shoes. 6 …”