Pitted keratolysis is a skin disorder caused by certain Gram-positive bacteria such as Corynebacterium spp. Affected individuals typically present with foot odor and multiple small pits on weight-bearing parts of their soles. Treatment comprises a change of footwear as well as the topical application of antimicrobials. The condition is associated with an excellent prognosis.
Pitted keratolysis (PK) has been observed in patients of any age, in shod and unshod populations distributed throughout the world . Nevertheless, a thorough anamnesis often reveals that patients used to wear tight, poorly breathable shoes for prolonged periods of time. In this context, PK is more frequently diagnosed in soldiers, sailors and athletes . Furthermore, barefooted people in tropical areas are prone to develop PK. The afore-described conditions favor growth and replication of the causative agents of the disease. In more than 90% of cases, both feet are involved .
As its name implies, the disease is associated with progressive proteolysis in the stratum corneum, which results in the appearance of characteristic pits on the plantar surface. Circular lesions appear as if they have been punched out, and they may measure up to 7 mm in diameter . Coalescence of pits may result in larger, crateriform skin defects. Less profound lesions of distinct size may also be observed. Affected skin may take on a pale, whitish tone, or become erythematous. It may be traversed by fissures . Lesions are most commonly located on the heels and weight-bearing metatarsal parts of the feet, although the disease tends to spread over the forefoot and towards the toes. Many patients describe an apparent exacerbation when soaking their feet in water  while the accentuation of skin lesions does indeed result from a swelling of the infected, eroded stratum corneum.
PK patients usually seek medical attention because of profuse sweating, sliminess of affected feet and socially unacceptable foot odor  . Hyperhydrosis is, however, not a prerequisite for the diagnosis of PK. Some patients may claim an itching or burning sensation while walking, and the condition may also be associated with pain.
In rare cases, PK may also affect the palms of the hands  . Here, scaling may be more pronounced than in plantar PK.
Entire Body System
Athletes and military personnel tend to develop this condition most commonly. [podiatry.org.mt]
But generally athletes and military personnel tend most to develop this. [almawiclinic.com]
Occupations at risk include: Farmers Athletes Sailors or fishermen Industrial workers Military personnel Females offering pedicure and foot care in a spa salon may also be affected by pitted keratolysis. [dermnetnz.org]
As this condition is caused by bacteria, it should come as no surprise that it is often present in military personnel or people who wear tight or restrictive footwear for extensive periods of time. [medicalpoint.org]
A plethora of pictures, slides & information at my fingertips. Well worth a look Once again, thanks. Regards :drinks To Da Vinci I wish to say thank you for the picture google link. [podiatryarena.com]
Many patients describe an apparent exacerbation when soaking their feet in water while the accentuation of skin lesions does indeed result from a swelling of the infected, eroded stratum corneum. [symptoma.com]
If you have a specific question or concern about a skin lesion or disease, please consult a dermatologist. [aocd.org]
Antifungal cream such as miconazole or clotrimazole With some combination of these treatments, the skin lesions and odor of pitted keratolysis usually disappear within 4 weeks. [podiatry.org.mt]
lesions and odor of pitted keratolysis usually disappear within 4 weeks. [skinsight.com]
With some combination of these treatments, the skin lesions and odour of pitted keratolysis usually disappear within 4 weeks. [almawiclinic.com]
A foot rash with a foul odor. Phys Sport Med. 1998. 26:104-6. Burkhart CG. Pitted keratolysis: a new form of treatment. Arch Dermatol. 1980 Oct. 116(10):1104. [Medline]. [emedicine.medscape.com]
PK is diagnosed clinically. The presence of multiple small pits on irritated, hyperhidrotic soles is considered pathognomonic of PK . The examination of affected skin with a Wood lamp typically reveals a pale yellowish or coral red fluorescence, but it has been pointed out that this is not an exclusion criterion  . Skin scrapings may be obtained for microscopic analysis. In the case of dermatomycosis like tinea pedis, treatment of specimens with potassium hydroxide should facilitate the observation of dermatophytes and spores. Of note, patients may suffer from PK and concomitant tinea pedis . If samples are taken for bacterial cultures, Gram-positive bacilli or coccobacilli (corresponding to Corynebacterium spp., Kytococcus sedentarius, or Dermatophilus congolensis) may be isolated  . Such procedures are rarely necessary, though. This also applies for the histopathological examination of biopsy specimens. If electron microscopy scanning is carried out for scientific purposes, hypokeratosis of the plantar skin and sweat gland ducts may be observed .
Pitted keratolysis is a skin disorder that affects the stratum corneum of the plantar surface and is caused by Gram-positive bacteria. A 30-year-old male presented with small punched-out lesions on the plantar surface. [ncbi.nlm.nih.gov]
Pitted keratolysis is a skin disorder caused by certain Gram-positive bacteria such as Corynebacterium spp. Affected individuals typically present with foot odor and multiple small pits on weight-bearing parts of their soles. [symptoma.com]
When it comes to bacterial skin infections, Pitted Keratolysis is a gram positive bacteria caused by the Micrococcus sedentarius. Pitted Keratolysis usually affects the soles of the feet and occasionally the palms of the hands. [skincareguide.com]
Indian J Dermatol Venereol Leprol 2005;71:213-5 The Corynebacteria are a diverse group of gram-positive bacilli which include Corynebacterium diphtheriae as well as a bewildering number of species that are found on the skin as part of the normal flora [ijdvl.com]
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- Longshaw CM, Wright JD, Farrell AM, Holland KT. Kytococcus sedentarius, the organism associated with pitted keratolysis, produces two keratin-degrading enzymes. J Appl Microbiol. 2002;93(5):810-816.