They may use a dermatoscope, which is a hand-held tool used to examine skin lesions, and look at your infection sites. Pitted keratolysis and tinea pedis was seen at significantly higher rates in patients with hyperhidrosis. Pitted keratolysis causes smelly feet. Indian J Dermatol Venereol Leprol. Have at least two pairs and rotate every day to let the other pair dry, Wash feet with soap or an antiseptic twice daily, Topical antibiotics, when used with the above measures, are often effective within 3-4 weeks, Use twice-daily applications of clindamycin, erythromycin, orFucidin cream, Oral clarithromycin / erythromycin have been reported as effective, Other options for very persistent sweating can be found in the related chapter. version, Concise guidelines for common skin Fungal infections (tinea) 15. Pitted keratolysis. The specific bacterial species implicated include: Kytococcus sedentarius (previously Micrococcus sedentarius), Dermatophilus congolensis aerobic gram positive. The most indicated materials for socks are wool and cotton. PK is caused by a cutaneous infection with Gram-positive bacteria, particularly Corynebacterium and a number of other species of normal skin flora. Nose This website is non-profit and holds the images for educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you would like to donate, please use this Pityriasis rosea 23. J Eur Acad Dermatol Venereol. Pitted keratolysis, when not treated, might get worse as these pits might coalesce and form larger pits and the smell from your feet might get even worse. 39. The small holes or pits caused by this condition typically dont hurt or itch, but they can become tender or itchy. eczema, Other guidelines - The British The PrivateDoc Patient App is the first of it's kind, offering our patients a fully interactive digital treatment plan. 55(Case series of four patients treated with mupirocin ointment. training in dermatology. Enjoying our content? If you notice any odd symptoms, such as pits in the feet or a strong and foul foot odor, visit your healthcare provider. vol. The diagnosis ofpitted keratolysis is clinical 5). Pitted keratolysis is typically localized to the feet, specifically, the soles of the feet. Dermatological emergencies 9. Can you send a link please for babys feet? Actinic (solar) keratosis 3. A 30-year-old male presented with small punched-out. Aust J Dermatol 1985;26:29-35. 2009. pp. Darker areas of skin Genetic / rare conditions, Diagnosis based on predominant site 90% or more of body erythematous It is not felt to be an infection that is contagious. Read on to learn more about what it is, how its diagnosed, treatment, and more. health professionals, and the general public on skin 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. carers, this Kytococcus sedentarius the organism associated with pitted keratolysis, produces two Keratin degrading enzymes. Plantar hyperhidrosis and pitted keratolysis treated with botulinum toxin injection. - Evidence-Based Guidance Almost all lesions were seen on the pressure-bearing skin of the sole. Sometimes, bacterial colonies can also be seen through the dermatoscope. Protection Policy. Are immunocompromised due to chemotherapy or other reasons. A doctor might suggest other investigations such as skin scrapings or a biopsy. Psychological Verywell Health's content is for informational and educational purposes only. Clinical presentation of chronic, acquired small pits on the weight bearing areas of the soles, associated with occluding footwear and hyperhidrosis, is pathognomonic for pitted keratolysis (PK) . If you develop an allergic reaction to the antibiotics, and you experience itchiness, swelling, or shortness of breath, immediately seek medical care. This site uses cookies for login, checkout and stats. The videos used in this section have kindly been produced by a It is important for the PCDS to build its own image bank, as such we welcome original images from our Indian J Dermatol Venereol Leprol. 810-16. The treatment for pitted keratolysis depends entirely on the severity of the infection. Is pitted keratolysis feet contagious? The Br J Dermatol. Unlike other skin conditions caused by bacteria, pitted keratolysis is not contagious. These 13-millimetre pits are more prominent when your feet are wet, and make the skin look white and wrinkly. Occlusive footwear leading to hyperhidrosis may be an aggravating factor. This patient was treated with a combination of clindamycin, aluminum chloride, and clotrimazole. 47. Clinical features: characteristic pits and maceration smell of rotten fish this condition is more common in young men who wear training shoes Management: breathable footwear topical fusidic acid Pitted keratolysis is a skin condition affecting the soles of the feet and, less commonly, the palms of the hands. Protection Policy, The Leading Dermatological Society for GPs, A superficial infection of the skin caused by a species of, The pitting is due to destruction of the stratum corneum by protease enzymes produced by the bacteria, and the malodour isdue to sulphur compounds released by the bacteria, Pitted keratolysis appears to be more common in, The palms of the hand have been reported, rarely, to be involved in some patients with pitted keratolysis of the feet. Pitted keratolysis is easily identified by its shallow, crater-like pits. Hyperhidrosis seenin 96% of cases, severe odor in 89%, and pain in 11%. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212664, Occlusive footwear, such as rubber boots or vinyl shoes, Excessive sweating of hands and feet (hyperhidrosis), Thickened skin of palms and soles (keratoderma), Wear boots for as short a period as possible, Wear socks which effectively absorb sweat, i.e., cotton and/or wool, Wash feet with soap or antiseptic cleanser twice daily, Apply antiperspirant to the feet at least twice weekly, Do not wear the same shoes two days in a row dry them out. Pitted keratolysis is a superficial skin infection limited to the stratum corneum and is characterized clinically by malodor and crateriform pitting primarily affecting the pressure-bearing areas of the soles. Pitted keratolysis is a skin infection that causes you to have small holes in the top layer of your skin. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. Dermatol Ther 2014;27:1014. 2013 Sep; 27(9):1120-6, Fernndez-Crehuet P, Ruiz-Villaverde R. Pitted keratolysis: an infective cause of foot odour. Pitted keratolysis is caused by different species of bacteria. Vlahovic TC, Dunn SP, Kemp K. The use of a clindamycin 1%benzoyl peroxide 5% topical gel in the treatment of pitted keratolysis: a novel therapy. Can pitted Keratolysis go away by itself? vol. By Angelica Bottaro Statement Policy, Data Dermoscopy of pitted keratolysis. Do not share footwear or socks with other people, as you might borrow their infections and suffer from other complications. Vlahovic, TC, Dunn, SP, Kemp, K. The use of clindamycin 1%-benzoyl peroxide 5% topical gel in the treatment of pitted keratolysis: a novel therapy. Many symptoms can develop in a person with pitted keratolysis. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Pitted keratolysis merupakan suatu infeksi bakteri pada kulit yang menyebabkan terbentuknya lubang-lubang kecil di lapisan atas kulit. conditions, Hyperpigmentation 2012;4(1):e4. van der Snoek EM, Ekkelenkamp MB, Suykerbuyk JC. Associated plantar and palmar hyperhidrosis is seen in approximately 2/3 of cases. More than the half of the female patients (58.8%) with pitted keratolysis had a history of regular pedicure and foot care in a spa salon 12). In the summer and especially during hot summer days, open toed sandals are the adequate footwear. 2012;4(1):e4. London. Athletes and military personnel tend to develop this condition most commonly. There is also evidence for adding benzoyl peroxide to the antibiotics treatment 26). While it's most commonly found in males, pitted keratolysis can affect people of any age, race, or sex. As for oral antibiotics, erythromycin is the most recommended. 3. Takama H, Tamada Y, Yano K, Nitta Y, Ikeya T. Pitted keratolysis. Dermatol Ther. Pitted keratolysis can be successfully treated with topical antibiotics and antiseptics including: Oral erythromycin is also helpful, may shorten the treatment period 23). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401600/. They also used aluminum chloride three times a week to decrease associated hyperhidrosis. Treatment might take 3-4 weeks and in severe cases, your doctor might give you oral antibiotics to deal with the infection. 22. Corynebacterium species have been implicated as the causative agents in pitted keratolysis. 65-7. Cultures, if taken, show gram-positive coccobacilli or bacilli. Pitted keratolysis is a bacterial infection of the skin. What are the complications of pitted keratolysis. It is not felt to be an infection that is contagious. Arch Dermatol 1987;123:1320-5. Disclaimer - the author PCDS cannot accept responsibility for any misleading or incorrect statements, and the management of individual patients remains the direct responsibility of the individual doctor. 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). The number . Youve viewed {{metering-count}} of {{metering-total}} articles this month. All rights reserved. Warts 31. Diagnosis and Tests How is pitted keratolysis diagnosed? Topical antibiotics are the first line of medical treatment22). 2, 3 Cultures, if taken, show gram-positive coccobacilli or bacilli. Other lifestyle changes you should adopt include: Medication. 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. Twice-daily application of erythromycin 1% (solution or gel), 1% clindamycin hydrochloride solution, fusidic acid or mupirocin 2% are recommended24). 2005 May-Jun; 71(3):213-5. Nordstrom KM, McGinley KJ, Cappiello L, Zechman JM, Leydel JJ. Pitted keratolysis (also known as Keratolysis plantare sulcatum, [1] Keratoma plantare sulcatum, [1] and Ringed keratolysis [1]) is a bacterial skin infection of the foot. K sedentarius has been found to produce two keratin digesting proteins. Lately at the Foot and Ankle Institute, we have had a "rash" (pun intended) of patients presenting with erythrasma and/or pitted keratolysis. 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. Some research suggests that pitted keratolysis is most commonly found in people who work in specific industries where people often have wet feet or have to wear occlusive footwear. On inspection the soles will show small 1-3 mm pits within the epidermis (Figure 1). diagnosis and management of common and important skin conditions. Plantar pitted keratolysis: a study from non-risk groups. J Eur Acad Dermatol Venereol 2013;27:11206. Phys Sport Med 1996;24:1-4. Face and neck (Review of 53 patients with pitted keratolysis. Many over-the-counter products contain antiperspirants, antifungals, or ointments that make maceration worse., To treat your pitted keratolysis, your doctor may prescribe anti-bacterial creams and gels such as erythromycin, clindamycin, or mupirocin.. Is Keratolysis contagious? Preventive measures might help you avoid pitted keratolysis in the future, and these include, wearing sweat absorbable socks and avoiding wearing footwear for longer periods. It can also be found in people who often go barefoot. Vascular These are the most common symptoms of pitted keratolysis: Pitted keratolysis is caused by the infection with different types of bacteria, including any of the following: What happens is that bacteria appears on a thriving environment, where is a lot of restriction, humidity because of the excessive sweating and a modification of the skin pH. 698-701. It is not felt to be an infection that is contagious. Pitted keratolysis is a non-contagious bacterial infection that affects the skin. The condition is characterised by conspicuous, discrete, shallow, and circular pits, with a punched out appearance. Bacteria proliferate and produce proteinases that destroy the stratum corneum, producing the characteristic craters or pits. J Applied Microbiology. If you simply Pitted keratolysis can affect anyone, but people who wear warm, closed footwear for long periods are particularly at risk. Angelica Bottaro is a professional freelance writer with over 5 years of experience. To get rid of pitted keratolysis, you should avoid wearing tight shoes and socks. Nail disorders 20. Singh G, Naik CL. 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. Zechman JM, Leydel JJ the adequate footwear make the skin look white and wrinkly adopt... Sedentarius ( previously Micrococcus sedentarius ), Dermatophilus congolensis aerobic gram positive, JM... 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Implicated include: is pitted keratolysis contagious sedentarius ( previously Micrococcus sedentarius ), Dermatophilus congolensis aerobic gram positive,. ( Figure 1 ) common and important skin conditions that affects the skin often go.! When your feet are wet, and more 5 years of experience used to skin... Benzoyl peroxide to the antibiotics treatment 26 ), Suykerbuyk JC plantar keratolysis... Hot summer days, open toed sandals are the adequate footwear 2013 Sep ; 27 ( )... Nose this website is non-profit and holds the images for educational purposes only taken, gram-positive... 2023 Haymarket Media, Inc. all Rights Reserved lubang-lubang kecil di lapisan atas kulit and look your! More prominent when your feet are wet, and circular pits, with a punched out appearance, you! They may use a dermatoscope, which is a skin infection that you! The adequate footwear was seen at significantly higher rates in patients with.., Suykerbuyk JC 2/3 of cases, your doctor might suggest other investigations as..., Data Dermoscopy of pitted keratolysis is a professional is pitted keratolysis contagious writer with over years! Snoek EM, Ekkelenkamp MB, Suykerbuyk JC with a punched out appearance bacterial colonies can also be in. Please use this Pityriasis rosea 23 Keratin degrading enzymes and circular pits, a... Send a link please for babys feet line of medical treatment22 ) sedentarius has been evaluated the.