Pitted keratolysis – a study of various clinical manifestations

Abstract

PK can involve web spaces, nonglabrous skin, and paronychium, and can cause nail changes. The lesions can be inflammatory with crusting and PIH.

Pitted keratolysis: An incidental finding in a 10 year old girl

“…Humidity aggravates it. The symptoms reported by affected persons are hyperhidrosis, foot odour and sometimes itching or burning while walking, but most cases are asymptomatic 1,4 . Diagnosis is chiefly based on the unique clinical findings on the soles.…”

“…Pitted keratolysis (PK) is a common bacterial infection of the skin, manifesting as noninflammatory superficial pits 1 . It mainly affects the stratum corneum of the plantar surface 2 .…”

Managing pitted keratolysis: consider topical glycopyrrolate

“…Moreover, substantive improvement in malodour, maceration and discomfort was reported without related AEs. A plausible explanation of the disease improvement in our case series is that glycopyrrolate‐induced sweat reduction may lessen bacterial colonization …”

“…Pitted keratolysis (PK), a noninflammatory bacterial infection of the plantar epidermis, is characterized by crateriform pitting, usually accompanied by hyperhidrosis and bromhidrosis. The predominantly isolated microorganisms include Corynebacterium spp, Kytococcus sedentarius and Dermatophilus congolensis . A combination of topical antibiotics (clindamycin, benzoyl peroxide, erythromycin, fusidic acid, mupirocin) and adjunctive measures (antiperspirants, appropriate hygiene and footwear) is considered the mainstay of treatment .…”

“…As excessive humidity stimulates bacterial growth and proliferation, elimination of plantar hyperhidrosis could be considered crucial in the management of PK . Botulinum toxin is effective but costly and painful, and sometimes complicated by muscle weakness .…”