Newer agents may be useful when microbiological diagnosis is established (eg, voriconazole for Aspergillus spp, posaconazole for zygomycetes), although further studies are required. Lastly, Van Damme and Hartman refer to noma (chancrum oris), a devastating necrotising destructive process of the face typically affecting young malnourished children in Africa. This condition has been presented in a recent excellent review by Baratti-Mayer and colleagues. 14 We thank Van Damme and Hartman for their interest in our paper, and their comments which allowed us to elaborate upon the most important topic of rapidly progressive SSTIs.