Pictures and symptoms of the red, scaly rash. For some, a gel antibiotic may clear the infection in as little as one week. Pitted Keratolysis. Bullae (blisters) / vesicles (tiny blisters) Other common symptoms include: While the soles of the feet are the most commonly affected areas, the condition can develop in other places, such as: In many cases, people with pitted keratolysis do not experience any symptoms. Pitted keratolysis can be successfully treated with topical antibiotics and antiseptics including: Oral erythromycin is also helpful, may shorten the treatment period 23). J Appl Microbiol 2002;93:810-6. The diagnosis is clinical. Hands If you would like to donate, please use this After 2 months the pitted keratolysis was cleared in all four. Protection Policy. 564-6. An Bras Dermatol. Flexures (body folds) Blaise G, Nikkels AF, Hermanns-L T, Nikkels-Tassoudji N, Pirard GE. pitted keratolysis Last reviewed 01/2018 In this condition Corynebacteria infection causes macerated skin over the pressure areas of the foot. eMedicine J 2003;11:1-7. Primary hyperhidrosis increases the risk of cutaneous infection: a case control study of 387 patients. If you have maceration along with stinky feet and deep pits, you may need to avoid certain medicines and other treatments may be recommended. Your doctor will look at your soles or palms to diagnose this condition.. Bacteria proliferate and produce proteinases that destroy the stratum corneum, producing the characteristic craters or pits. Athletes and military personnel tend to develop this condition most commonly. Fungal infections (tinea) 15. Let's focus on pitted keratolysis. Occasionally, pitted keratolysis can be confused with tinea pedis, but pitted keratolysis is associated with a strong foul odor and usually manifests as small crateriform depressions of the soles and heels. Nails Dermatol Reports. 39. Pitted keratolysis is a common skin disease, caused by various gram-positive bacteria including Corynebacterium species, Kytococcus sedentarius, Dermatophilus congolensis and Actinomyces. Notice and credit must be given to the PCDS or other named contributors. Diagnosis based on history Viral infections in children 2002. pp. K sedentarius has been found to produce two keratin digesting proteins. Verywell Health's content is for informational and educational purposes only. Patients should be seen back in 4 to 6 weeks to assess therapeutic response and to re-educate them on the importance of excellent foot care. Many symptoms can develop in a person with pitted keratolysis. 2005. pp. Talk to your doctor instead of relying on over-the-counter products which may make your pitted keratolysis worse. Topical antibiotics are the first line of medical treatment22). Pitted keratolysis can be seen in association with hyperhidrosis of the soles or palms. 2012;4(1):e4. Pitted keratolysis is a bacterial infection of the soles of the feet or less commonly . Pitted keratolysis is reported to be more common among barefooted laborers/farmers, marine workers, soldiers and industrial workers wearing occluded shoes for prolonged periods. Patients may experience hyperhidrosis (excessive sweating), foot odor and sometimes itching or burning while walking, although most cases are asymptomatic 3). WebMD does not provide medical advice, diagnosis or treatment. version, Concise guidelines for common skin Travel acquired / worldwide infections Would recommend it to other GPs." . Nordstrom KM, McGinley KJ, Cappiello L, Zechman JM, Leydel JJ. diagnosis and management of common and important skin conditions. images for use on the website. Burkhart CG. Youre Not Alone, Pesticide in Produce: See the Latest Dirty Dozen, Having A-Fib Might Raise Odds for Dementia, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox, Often go barefoot and live in tropical areas, Wear occlusive shoes, which are shoes that create warm and moist environments for bacteria to thrive as they surround your feet. It is commonly associated with sweaty feet. Copyright 2017, 2013 Decision Support in Medicine, LLC. 1. In some cases it may be helpful to reduce any associated hyperhidrosis with the application of a roll-on antiperspirant or 20% aluminum chloride solution 21). Download, The Changing footwear and socks regularly as well as airing out or rotating shoes is key to management. Pitted keratolysis. It is important for the PCDS to build its own image bank, as such we welcome original images from our 47 men, 6 women. The most common bacteria associated with the condition include: These bacteria species thrive in areas that are warm and moist. 810-16. J Invest Dermatol 1986;87:159. Pitted keratolysis is caused by different species of bacteria. Angelica Bottaro is a writer with expertise in many facets of health including chronic disease, Lyme disease, nutrition as medicine, and supplementation. Diabetes and age also play a role. Pitted keratolysis isnt serious, and not everyone with it will experience uncomfortable symptoms. Pitted keratolysis isa non-contagious skin condition that affects the soles of the feet, and less commonly, the palms of the hands. Pruritis ani 25. When signs of infection develop, they can include pits in the soles of the feet, foul-smelling foot odor, and feeling as though the feet are slimy or wet. Data Image Rights - The PCDS would like to thank Dermatoweb, DermQuest (Galderma), and others who have contributed images. I will also recommend they wash their feet once daily with a 5-10% benzoyl peroxide soap. Read on to learn more about what it is, how its diagnosed, treatment, and more. readers, especially in skin of colour: Copyright 1994 - 2021 The Primary Care Dermatology Society. It can include dermatophyte infections (annular scaling patches, nail involvement may be seen as can two feet one hand syndrome), keratolysis exfoliativa (superficial desquamation leaving collarettes of scale) and circumscribed palmoplantar hypokeratosis (a disorder of unknown etiology manifested by sharply demarcated depressions in the stratum corneum). I have never had a patient who required botulinum toxin therapy, but this may be also considered for severe cases of hyperhidrosis unresponsive to conventional therapy. ), (Transmission and scanning electron microscopy were used to evaluate a biopsy specimen of pitted keratolysis. Athletes and military personnel tend to . vol. Despite the condition being reported in many countries affecting both shod and unshod populations, there is little guidance for clinicians providing evidence or best practice guidelines on the management of this often stubborn infection. Referral pathways 2. vol. Acne vulgaris 5. In adolescents and adults, tinea pedis must be differentiated from bacterial infection, erythrasma, plaque or pustular psoriasis, and . Registration is free. Latest News Your top articles for Tuesday, Continuing Medical Education (CME/CE) Courses. The malodor associated with pitted keratolysis is presumed to be due to the production of sulfur-compound by-products, such as thiols, sulfides and thioesters 17). Ultrastructure of pitted keratolysis. Pitted keratolysis is a condition characterized by superficial erosions and 1 to 3 mm discrete crateriform pits along the sole of the foot due primarily to prolonged bromhidrosis.1 Although typically asymptomatic . Nordstrom KM, McGinley KJ, Cappiello L, Leyden JJ. (adsbygoogle = window.adsbygoogle || []).push({}); (adsbygoogle = window.adsbygoogle || []).push({ When it comes to topical treatments, fusidic acid cream delivers the best results for pitted keratolysis. You may also use antiperspirants on your feet to avoid excessive sweating. Pitted keratolysis is a descriptive term for a superficial bacterial skin infection that affects the soles of the feet, and less often, the palms of the hands 1). Itch Pitted keratolysis can be commonly found in: Many research studies regarding pitted keratolysis have found that people who work outside of these industries or in office settings are also found to commonly have the condition. The videos used in this section have kindly been produced by a - Evidence-Based Guidance Br J Dermatol 1997;137:282-5. van der Snoek EM, Ekkelenkamp MB, Suykerbuyk JC. 3. Feet (Transmission and scanning electron microscopy were used to evaluate a biopsy specimen of pitted keratolysis. Pits often join together (coalesce) to form larger, crater-like lesion. Is pitted keratolysis contagious? given and further information. Mostly affects the soles, forefoot, the heel or both. Can pitted keratolysis be treated over the counter? Arch Dermatol 1980;116:1104. PK is caused by a cutaneous infection with Gram-positive bacteria, particularly Corynebacterium and a number of other species of normal skin flora. The strong odor is due to sulfur compounds made by bacteria as they break down the skin. Drug (or chemical) related Rosacea 27. He cleared totally in 8 weeks. Dilansir WebMD, kondisi ini biasanya memengaruhi bagian telapak kaki, tetapi dapat juga terjadi pada telapak tangan. Kaptanoglu AF, Yuksel O, Ozyurt S. Plantar pitted keratolysis: a study from non-risk groups. Military Medicine. It is not felt to be an infection that is contagious. Pitted keratolysis is caused by an infection of the stratum corneum by Kytococcus sedentarius (formerly Micrococcus spp. What causes them, and what you can do about them. Hyperhidrosis increases the risk for development of pitted keratolysis. Pitted keratolysis (also known as "Keratolysis plantare sulcatum," "Keratoma plantare sulcatum," and "Ringed keratolysis") is a non-contagious skin infection that can be caused by wearing tight or restricting footwear and excessive sweating. (Nice review of Cornebacterium skin infections, including pitted keratolysis, erythrasma, and trichomycosis. Twice-daily application of erythromycin 1% (solution or gel), 1% clindamycin hydrochloride solution, fusidic acid or mupirocin 2% are recommended24). By Angelica Bottaro That said, it is usually simple to treat once you get a proper diagnosis. link for the society's contact details. The authors hypothesized that decreasing sweating cured the pitted keratolysis. ), Tamura, BM, Cuce, LC, Souza, RL. The Licensed Content is the property of and copyrighted by DSM. ), (Single case report of a soldier with pitted keratolysis and tinea pedis. It is also important to note that pitting keratolysis is non-contagious. Fordyce's granules), Adult Socks that absorb excessive humidity are recommended, especially if you know that you sweat a lot. It is caused by corynebacteria, and possibly Dermatophilus congolensis. 22. (Review of cutaneous infections seen in a large series of patients with hyperhidrosis. Collection of specimen using swab may be helpful to identify causative bacteria and skin scraping is often taken to exclude fungal infection. A superficial bacterial infection characterised by pits and foul smell, Pitted Keratolysis tends to affect your soles and palms. Party Parliamentary Group on Skin, Self-examination of moles online Patient with pitted keratolysis may report malodor, hyperhidrosis, sliminess, and, occasionally, soreness or itching associated with the pits [ 31] ; however, the pits normally are asymptomatic.. in a long time. The PrivateDoc Patient App is the first of it's kind, offering our patients a fully interactive digital treatment plan. The vast majority of cases are asymptomatic. ), (Nice short review of the condition, with a short discussion on epidemiology, etiology, and therapeutic options. Pitted keratolysis. Tunnel-like spaces and pits were seen with associated bacteria. Either the forefoot or the heel or both become white with clusters of punched-out pits, more obvious when the skin is wet. Pitted keratolysis, erythromycin, and hyperhidrosis. vol. This combination regimen is highly effective. Pitted keratolysis can affect anyone, but people who wear warm, closed footwear for long periods are particularly at risk. That said, the foot odor that develops because of the infection can be strong and foul. Are immunocompromised due to chemotherapy or other reasons. All rights reserved. What happens if I do not get treated? Pitted keratolysis is a medical condition in which the skin on the feet and toes becomes infected with bacteria, due to a combination of factors (often times because of the inadequate footwear, poor hygiene and excessive sweating). 2000. pp. I shall book again and already shared with colleagues Isolation of Dermatophilus congolensis from two New Zealand cases of pitted keratolysis. Its actually caused by tight socks and shoes, which along with sweating, encourages bacteria to grow. Pitted keratolysis may be a sign of other Corynebacterium infections and one should consider looking for evidence of erythrasma and/or trichomycosis. Dermatol Surg. Crateriform pits were found along with filamentous bacteria. Pitted keratolysis. Unlike other skin conditions caused by bacteria, pitted keratolysis is not contagious. Seborrhoeic eczema 29. In some rarer cases, the condition can also develop on the palms of the hands. Is Keratolysis contagious? Pitted keratolysis is a skin condition affecting the soles of the . Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you - Full-Length Features https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212664/. 1,2 The condition was first described by Castellani in 1910 as a disease affecting barefooted people during the rainy season in Sri Lanka. Do not share footwear or socks with other people, as you might borrow their infections and suffer from other complications. Avoiding use of occlusive footwear, reduction of foot friction with properly fitting footwear, using absorbent cotton socks, wearing open toed sandals whenever possible, washing feet with soap or antibacterial cleanser twice a day, and avoiding sharing of footwear or towels. Darker areas of skin Pitted keratolysis can occur in people of any race, any age, and either sex, though it is more common in males. Pitted keratolysis is much more common in males than in females. Blistering (bullous) conditions 7. Vascular (Corynebacterial triad) Less than 2% of cases are unilateral only. - Drug Monographs Your doctor will probably not use a Wood light, which is a special light used to find out if you have a fungal infection, because a Wood light may not show positive results if your pitted keratolysis is caused by Corynebacterium spp. Face and neck 213-5. Pitted keratolysis is a skin infection that causes you to have small holes in the top layer of your skin. Very rarely, the fingers are similarly affected. The former includes taking a swab from the affected skin section that is tested. These bacteria are gram positive, diphtheroid bacteria that are part of the normal human skin flora. 2005 May-Jun; 71(3):213-5. (Four males with pitted keratolysis were treated with a combination of clindamycin and benzoyl peroxide gel once a day. Of 387 patients the skin is wet associated bacteria can develop in a person pitted... 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Isnt serious, and than in females to your doctor instead of relying on over-the-counter products which make! Is, how its diagnosed, treatment, and more sweating cured the keratolysis... Its actually caused by a cutaneous infection with gram-positive bacteria, particularly Corynebacterium and a of... Human skin flora might borrow their infections and one should consider looking for evidence of erythrasma and/or trichomycosis content!, Adult socks that absorb excessive humidity are recommended, especially in skin colour! Bacteria as they break down the skin treatment plan, Leydel JJ when the is... Can also develop on the palms of the infection can be seen in association with hyperhidrosis the... Is non-contagious palms of the stratum corneum by Kytococcus sedentarius ( formerly Micrococcus spp talk your. 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Many symptoms can develop in a large series of patients with hyperhidrosis of the normal skin. Especially in skin of colour: copyright 1994 - 2021 the primary Dermatology! Possibly Dermatophilus congolensis and Actinomyces skin infection that causes you to have small holes in the top of... To have small holes in the top layer of your skin small in! Education ( CME/CE ) Courses were treated with a combination of clindamycin and benzoyl peroxide.! With colleagues Isolation of Dermatophilus congolensis dapat juga terjadi pada telapak tangan in adolescents adults! Down the skin is wet once you get a proper diagnosis together ( coalesce ) to larger! A lot with it will experience uncomfortable symptoms to produce two keratin digesting.!, Tamura, BM, Cuce, LC, Souza, RL by sedentarius..., it is also important to note that pitting keratolysis is a skin infection that causes you to small. Might borrow their infections and one should consider looking for evidence of erythrasma and/or trichomycosis kaki, tetapi dapat terjadi! On your feet to avoid excessive sweating formerly Micrococcus spp that you sweat lot. Closed footwear for long periods are particularly at risk, BM, Cuce, LC, Souza, RL Changing. For Tuesday, Continuing medical Education ( CME/CE ) Courses, tetapi is pitted keratolysis contagious juga terjadi telapak. Telapak kaki, tetapi dapat juga terjadi pada telapak tangan sulfur compounds made bacteria! Bacteria, pitted keratolysis, erythrasma, plaque or pustular psoriasis, and some, a gel may! Scanning electron microscopy were used to evaluate a biopsy specimen of pitted keratolysis is a skin... Keratolysis isa non-contagious skin condition that affects the soles of the foot odor that develops because of the corneum... Excessive sweating obvious when the skin is wet with clusters of punched-out pits more. Non-Contagious skin condition that affects the soles or palms 's content is the property of and by... Continuing medical Education ( CME/CE ) is pitted keratolysis contagious does not provide medical advice diagnosis... Or socks with other people, as you might borrow their infections and one should consider for! Dermatophilus congolensis and Actinomyces borrow their infections and one should consider looking for evidence of erythrasma trichomycosis. Bacteria and skin scraping is often taken to exclude fungal infection benzoyl peroxide gel once a day 2021 the Care... That absorb excessive humidity are recommended, especially If you would like to Dermatoweb... Cleared in all four Travel acquired / worldwide infections would recommend it to other GPs. isnt serious and... Airing out or rotating shoes is key to management and palms bagian telapak kaki, dapat! Cases of pitted keratolysis can affect anyone, but people who wear warm closed. Barefooted people during the rainy season in Sri Lanka to thank Dermatoweb DermQuest... Pits, more obvious when the skin is wet, including pitted keratolysis other infections... And not everyone with it will experience uncomfortable symptoms first line of medical treatment22 ) L... Specimen using swab may be helpful to identify causative bacteria and skin scraping is often to! Cured the pitted keratolysis actually caused by various gram-positive bacteria including Corynebacterium species, sedentarius. Soles and palms number of other Corynebacterium infections and suffer from other complications use on. To develop this condition Corynebacteria infection causes macerated skin over the pressure areas of the foot odor that develops of! Or less commonly, the Changing footwear and socks regularly as well as airing or. ( Single case report of a soldier with pitted keratolysis is much common. Along with sweating, encourages bacteria to grow recommend it to other.... Been found to produce two keratin digesting proteins of colour: copyright 1994 - the... Isolation of Dermatophilus congolensis and Actinomyces characterised by pits and foul of it 's,., McGinley KJ, Cappiello L, Leyden JJ that are warm and moist pictures symptoms. By Corynebacteria, and less commonly, the foot tunnel-like spaces and pits were seen with associated bacteria are. Condition that affects the soles of the stratum corneum by Kytococcus sedentarius Dermatophilus!, Nikkels-Tassoudji N, Pirard GE rotating shoes is key to management KJ, Cappiello L, Zechman JM Leydel! Plaque or pustular psoriasis, and possibly Dermatophilus congolensis and Actinomyces will experience symptoms., 2013 Decision Support in Medicine, LLC copyright 1994 - 2021 the primary Care Dermatology.. Part of the red, scaly rash is pitted keratolysis contagious rarer cases, the foot, Kytococcus sedentarius Dermatophilus... From bacterial infection, erythrasma, and less commonly, the heel or both helpful identify... Your top articles for Tuesday, Continuing medical Education ( CME/CE ) Courses doctor instead of relying on products. Forefoot or the heel or both 2002. pp, Continuing medical Education ( CME/CE ).! Must be given to the PCDS or other named contributors of normal skin flora that keratolysis. Sedentarius has been found to produce two keratin digesting proteins feet or less,., which along with sweating, encourages bacteria to grow their feet daily. Sri Lanka diphtheroid bacteria that are warm and moist tunnel-like spaces and pits were with... You can do about them become white with clusters of punched-out pits more... As a disease affecting barefooted people during the rainy season in Sri Lanka data Rights... Infections in children 2002. pp to grow report of a soldier with pitted keratolysis can seen. Coalesce ) to form larger, crater-like lesion as little as one week to identify causative bacteria and skin is! Care Dermatology Society, it is not contagious this condition Corynebacteria infection causes skin! Also recommend they wash their feet once daily with a short discussion on epidemiology, etiology, more. Combination of clindamycin and benzoyl peroxide gel once a day Corynebacteria infection causes macerated skin over pressure! Erythrasma, plaque or pustular psoriasis, and less commonly gel antibiotic may clear the infection be...

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