Pitted keratolysis: a case report and review of current literature

Abstract

The article offers a brief history of pitted keratolysis (PK), research regarding PK etiology, evaluation of PK, and current treatment modalities. The main objective of this article focuses on the current literature on PK, its presentation and symptomatology, prevalence, and available therapeutic options. We present a case report and review on PK of a patient treated with an over the counter antiperspirant, topical erythromycin, oral erythromycin, and proper education on hygiene, with complete resolution and without recurrence after a follow up of greater than 12 months.

Pitted Keratolysis

“…Pitted keratolysis (PK) is a relatively frequent superficial bacterial skin infection that typically affects pressure-bearing areas of the soles. [1][2][3][4][5] Etiological agents include Corynebacterium spp, Micrococcus sedentarius, Dermatophilus congolensis, Streptomyces, and Actinomyces keratolytica. [3][4][5] These bacteria produce proteases that digest keratin and destroy the stratum corneum, resulting in the characteristic crateriform pitting and erosions.…”

“…5 Most cases are asymptomatic, although pruritus and a burning or pain sensation may occur on walking. [2][3][4][5] Predisposing factors include hyperhidrosis, prolonged use of occlusive footwear, humid climate, poor foot hygiene, obesity, diabetes mellitus and immunodeficiency. [2][3][4][5] Adolescents and young adults are more commonly affected.…”

“…[2][3][4][5] Predisposing factors include hyperhidrosis, prolonged use of occlusive footwear, humid climate, poor foot hygiene, obesity, diabetes mellitus and immunodeficiency. [2][3][4][5] Adolescents and young adults are more commonly affected. 5 There is no racial predilection, but there is a male predominance, presumably due to males' frequent use of occlusive footwear.…”

“…5 There is no racial predilection, but there is a male predominance, presumably due to males' frequent use of occlusive footwear. 2,5 The diagnosis is clinical. 3,5 Main differential diagnosis include plantar warts and tinea pedis.…”