Pitted Keratolysis

From Anvita Health Wiki

Contents 1 Etiology 2 Epidemiology 3 Clinical-manifestations 4 Laboratory 5 Differential-diagnosis 6 Management 7 More General Terms 8 Additional Terms 9 References

Etiology

• Micrococcus sedentarius
• hyperhidrosis of the feet predisposes

Epidemiology

• affects mostly young adults
• affects males >> females

Clinical-manifestations

• pits in stratum corneum of plantar foot 1-8 mm in diameter
• pits may be discrete, but more often become confluent forming large areas of eroded stratum corneum
• involved areas are white when stratum corneum is fully hydrated
• symmetric or asymmetric involvement of both feet
• distribution: toe webs, balls or heel of foot in contact with shoe
• generally asymptomatic, but may be associated with itching, burning or tenderness
• foot odor

Laboratory

• no hyphae in 10% KOH preparations from skin scrapings
• Wood's lamp: negative for coral-red fluorescence ( erythrasma)
• culture (rule out Staphylococcus aureus, group A streptococcus, Pseudomonas aeruginosa)

Differential-diagnosis

• tinea pedis
• Candida intertrigo
• erythrasma
• gram-negative bacillus web infection

Management

• prophylaxis

• wash with lather from benzoyl peroxide soap bar
• antiperspirants ( AlCl3)

• treatment

• benzoyl peroxide: apply daily
• topical erythromycin: apply daily

More General Terms

• bacterial infection
• skin infection

Additional Terms

• keratolysis
• Micrococcus sedentarius

References

Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 620-21

pitted keratolysis