Vamp Disease: Inflammation of the Great Toe Due to Pressure From Women's Shoes

We have reported the case histories and biopsy findings of seven women who developed inflammatory swellings on the dorsal aspect of the base of the hallux, secondary to irritation from the edge of the vamp of a shoe. The swelling is characterized by a horn-filled sinus, resembling a clavus, on the surface. The process may extend deeply to involve the extensor hallucis longus tendon. Avoiding the ill-fitting shoes is probably the most important therapeutic measure, but incision and drainage during the subacute state and possibly excision of any residuum may be necessary at a later date.