Pitted keratolysis

Pitted keratolysis
Other names	Keratolysis plantare sulcatum, Keratoma plantare sulcatum, Ringed keratolysis,[1] and sweaty sock syndrome[2]
Right foot affected with pitted keratolysis
Specialty	Dermatology
Symptoms	Large, crater-like holes on the foot
Causes	Corynebacterium species and other bacteria
Differential diagnosis	Athlete's foot (Tinea pedis), erythrasma, hyperhidrosis
Prevention	Keeping the feet dry, antiperspirants
Treatment	Antibiotics

Pitted keratolysis (also known as keratolysis plantare sulcatum,^[1] keratoma plantare sulcatum,^[1] and ringed keratolysis^[1]) is a bacterial skin infection of the foot.^[2] The infection is characterized by craterlike pits on the sole of the feet and toes, particularly weight-bearing areas.

The infection is caused by Kytococcus sedentarius.^[2][3] Excessive sweating of the feet and use of occlusive footwear provide an environment in which these bacteria thrive and therefore increase the risk of developing pitted keratolysis.^[2][4]

The condition is fairly common, especially in the military where wet shoes/boots are worn for extended periods of time without removing/cleaning. Skin biopsy specimens are not usually utilized, as the diagnosis of pitted keratolysis is often made by visual examination and recognition of the characteristic odor. Wood's lamp examination results are inconsistent. Treatment of pitted keratolysis requires the application of antibiotics to the skin such as benzoyl peroxide, clindamycin, erythromycin, fusidic acid, or mupirocin.^[2][5] Prevention efforts aim to keep the feet dry by using moisture-wicking shoes and socks as well as antiperspirants.^[2]