I have been treating a pt with a sinus like wound on her R3rd toe, it is slightly proximal and lateral to the lateral sulci. Upon light incidental compression while cleaning the wound a white/cream paste oozed out of the sinus, it has a similar consistency to toothpaste. (Imagine squeezing toothpaste out of a tube)
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The same paste was also present deep to HK on the apex of left 3rd toe, This appeared post debridement, unlike the right foot the distribution was more cyst like approx 5x3mm and i was able to probe to bone.
A swab + sample of paste has been sent off. to pathology as signs point to a possible infection, however, I was curious as to what some of the differential diagnoses may be??? Sebum? lymph issues? Evidence of previous infection? Infection? I have not seen this before and being new to the profession and on a rural visit to a hospital, I did not have anyone to discuss with.
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