Our 25 years of experience with treating patients with recurrent skin infections has resulted in a rational plan that usually solves this diagnostic enigma. Our evaluation consists of a comprehensive examination of the infected tissue, as well as a search for systemic factors and diseases that interfere with host defenses and/or the biology of wound repair. Patient assessment begins with a detailed history, a search for foreign bodies in the wound, as well as histologic and microbiologic examinations of the infected tissue. Clinical recognition and laboratory evaluation for metabolic and endocrinologic dysfunction, a deficiency of the immune system, protein-calorie malnutrition, or a specific defect in collagen synthesis are other integral components of our diagnostic plan for patients with recurrent skin infections.