Pitted keratolysis is a bacterial skin infection that affects the soles of the feet, and sometimes the palms of the hands. It is characterized by small pits or craters on the skin’s surface, and is particularly common among people whose feet sweat excessively.

Causes: Pitted keratolysis is primarily caused by Corynebacterium, although other bacteria like Dermatophilus congolensis and Actinomyces can also be involved. These bacteria thrive in moist environments, making excessive sweating a significant risk factor.

Symptoms:

  • Small, shallow pits on the skin of the feet, often concentrated on the pressure areas like the heel or ball of the foot.
  • A foul odor, due to compounds produced by the bacteria.
  • Occasionally, a feeling of tenderness or soreness in the affected areas.

Treatment: Treatment typically involves:

  • Keeping the feet dry and clean.
  • Using antibacterial soaps and applying topical antibiotics such as clindamycin or erythromycin.
  • In some cases, oral antibiotics might be prescribed if the infection is severe or recurrent.
  • Using antiperspirants to reduce sweating, or changing socks frequently and using absorbent shoe inserts.

Prevention: Maintaining foot hygiene is crucial for preventing pitted keratolysis. This includes drying feet thoroughly after washing, wearing moisture-wicking socks, and choosing breathable footwear. Regularly changing socks and shoes to ensure they are dry can also help reduce the risk.

As a podiatrist, you might also suggest routine checks for patients who are particularly at risk, such as athletes or individuals who work in wet conditions.