Pitted Keratolysis
Pitted Keratolysis
Key Points
Skin condition which affects the soles of the feet
Caused by bacterial infection related to the presence of hyperhydrosis
Consists of skin becoming white in color and the formation of groups of pits in the affected area
Pitted keratolysis is a skin condition which affects the soles of the feet. Typically, initially presentation consists of the skin on the heel and/or ball of the foot turning white. Groups of pits, which resemble areas of skin which have been punched out, then form in the affected area. This will be accompanied by strong foot odor. In extremely rare cases, the condition may involve the fingers. In some cases, diffused red areas may appear on the sole of the foot. The condition appears worse when the affected area is wet.
The condition may also recur up to several weeks after healing.
Pitted keratolysis is caused by a bacterial infection of the sole, and is typically associated with hyperhydrosis. This is especially evident if the affected person uses occlusive footwear on a regular basis for long periods of time.
Differential Diagnosis (Other conditions with similar appearance)
Various skin cancers
Dermatofibrosarcoma protuberans
Neurilemoma
Eruptive Vellus Hair Cysts
Osteoma Cutis
Follicular Infundibulum Tumor
Folliculitis
Trichilemmoma
Folliculoma
Trichoepithelioma
Insect Bites
Trichofolliculoma
Keratoacanthoma
Diagnosis
Key Points
Diagnosis based on imaging tests of the affected area
Skin biopsy will be performed to confirm diagnosis and rule out other conditions
Pitted keratolysis is typically diagnosed based on imaging tests, such as ultrasound, MRI and CT scans, of the affected area. A skin biopsy will be performed to confirm the diagnosis and to rule out similar appearing conditions.
Treatment
Keeping the affected area dry is recommended to prevent recurrence
*Treatment typically consists of topical or oral antibiotics.
Treatment of pitted keratolysis typically consists of the administration of topical or oral antibiotic courses. It is also recommended that affected persons keep the area dry to prevent recurrence.