Pitted Keratolysis - Medtick
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Pitted Keratolysis

What is it?

A bacterial condition on the foot (rarely fingers) that is mistaken for widespread athlete’s foot, due to high sweating feet (working in hot, humid, environments, playing sports, athletes, sailors, farmers) and excess sock/shoes (particularly rubber boots or vinyl shoes) wearing, this creates a moist environment for bacteria to grow.

  • It normally occurs on the bottom of the feet (mainly forefeet) and the heel and is a ‘come and go’ condition.
  • It can causes a ‘pitted like appearance’ due to the fact the bacteria destroys the outer skin layer.
  • The bad smell is of sulphur caused by the bacteria.
  • It is more common in males than females.
  • Increased risk this condition is due to:

Cause

  • Bacteria living in moist conditions:
    • Corynebacteria
    • Dermatophiluscongolensis
    • Kytococcussedentarius
    • Actinomyces
    • Streptomyces

Symptoms

  • Smelly feet?
  • Fingers (rare), Forefoot and/or the heel become white with clusters of punched-out pits (appearance is more dramatic when the feet are wet)?
  • Pits often join together to form larger, crater-like lesion?
  • Pits vary in colour with red areas on the soles?
  • Soreness or itching when walking?
  • One work in moist, hot and humid environments?

Complications /Information to beware of/General tips:

Prevention

  • Pitted keratolysis will quickly recur unless the feet are kept dry.
  • The following precautions should be taken to prevent recurrences:
    • Wear boots for as short a period as possible
    • Wear socks which effectively absorb sweat, i.e. cotton and/or wool or moisture-wicking materials i.e. polyester and nylon
    • Wear open-toed sandals whenever possible
    • 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
    • Do not share footwear or towels with others.

DermNet NZ

Treatment

  • To treat pitted keratolysis, your Medical Doctor will most likely prescribe a topical antibiotic or antiseptic, do not use benzoyl peroxide (used for acne and spots) unless the Medical Doctor has told you so.
  • It will take 3- 4 weeks  to clear (so please be compliant with medication) with medication and prevention methods stated above.
  • This condition can be mistaken for widespread athlete’s foot.
  • Treat this condition as soon as possible as without treatment, the pits can coalesce together to form larger crater-like depressions in the skin. The odour may also get worse.

This condition may show similar symptoms to:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

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