Pitted keratolysis is a bacterial infection of the skin. It can affect the palms of the hands and, more commonly, the soles of the feet, particularly the weight-bearing areas.
This infection causes small depressions, or pits, in the top layer of the skin. It can also lead to a bad smell.
Pitted keratolysis usually affects people who wear enclosed warm footwear for long periods, including soldiers, sailors, and athletes. It also tends to be commonTrusted Source in tropical areas where people usually go barefloot.
The bacteria species Kytococcus sedentarius, Dermatophilus congolensis, Corynebacterium, or Actinomyces usually cause the infection.
These bacteria thrive in moist environments. According to the American Osteopathic College of Dermatology, pitted keratolysis has an association with excessive sweating, but this is not its only cause.
Perspiration, along with tight fitting socks or shoes, creates the perfect conditions for the bacteria to multiply.
Other risk factors for pitted keratolysis include:
📌 not drying the feet thoroughly after bathing
📌 not wearing absorbent socks
People whose occupation may increase their risk of pitted keratolysis include:
📌 athletes
📌 sailors and fishing workers
📌 industrial workers
Other risk factors that can make someone more likely to develop pitted keratolysis include:
📌 hot, humid weather
📌 having thickened skin on the palms or soles
📌 having diabetes
📌 being older
📌 having a compromised immune system
🍎Symptoms:
The main symptom of the infection is clusters of small pits in the top layer of the skin on the soles of the feet. Each pit is usually 1–3 millimeters in size. The skin may also look white or wrinkly.
The pits usually cluster around the balls of the feet, the heels, or both. They tend to appear more pronounced when the feet are wet. Without treatment, the pits can join together to form a large crater-like lesion.
Pitted keratolysis can also cause an unpleasant smell, but people do not usually experience any redness or swelling because this condition is not an inflammatory skin condition.
Less commonly, the infection can affect the hands. When this happens, the characteristic pits usually occur on the palms.
Treatment
A doctor will usually prescribe a topical antibacterial medication to treat the infection. Popular choices include:
erythromycin
clindamycin
mupirocin
fusidic acid
benzoyl peroxide
Rarely, the doctor may also recommend oral antibiotics, such as erythromycin or clindamycin. Effective treatment will usually clear the lesions and the smell in 3-4 weeks trusted source.
The doctor may also treat excessive sweating if it is contributing to the disorder. Aluminum chloride 20% solution or the off-label use of botulinum toxin injections are options that can decrease sweating.