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Keratoderma help please??

Discussion in 'General Issues and Discussion Forum' started by Blue123, Nov 2, 2010.

  1. Blue123

    Blue123 Active Member

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    Hi again everyone,

    Having just returned from work i have a particular patient on my mind, they presented with painful feet and has put off seeing a podiatrist until being 'forced' by his partner. Anyway he is a tradesman and therefore always in hot work boots etc, the area in question is primarily his heels and it almost like a pitted hyperkeratosis and on debridement it became very moist and felt almost 'rubbery'; similar presentation on both 2nd - 4th mtpj and slight tinea pedis interdigitally on both feet. Can anyone help???

    The patient reported it gets worse in summer and has only been a problem in the last year, the patient is approx 40 years old.
  2. Lauren84

    Lauren84 Member

    Do you have any pictures?
  3. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Think Pitted Keratoylsis.

    Do some googling and see if the pictures look similar to your patient.

  4. Aldrin C

    Aldrin C Member

  5. Mr C.W.Kerans

    Mr C.W.Kerans Active Member

    Suggest regular debridement as necessary. Several changes of socks each day - soiled socks can be put in Zip-Lok bags - after application of Surgical Spirit, Methylated Spirit or equivalent for antiseptic cleaning and astringent effect. I would reserve antiperspirant in case of further irritation of macerated skin. Scrupulous attention to foot hygiene to deal with bromhidrosis.
  6. Mijel84

    Mijel84 Active Member


    It Is similary?

    This is a bacterial infection (Corynebacterium)

    The patient is constantly wet feet and smelly, ¿?

    My protocol:

    oral erythromycin
    washed with chlorhexidine, all nights
    treat sweating
    In 1 or 2 months the problem is solved. It may help topical mupirocin and wash with acid soap.

    Attached Files:

  7. Blue123

    Blue123 Active Member

    I have no pics, it looks very similar to your suggestions of pitted keratolyis and i am going to discuss with my patient the relevant treatment plan. Thanks guys!

    It seems much more 'horny' than these pics, however he presented to me with wet feet and i believe this makes the appearance more severe
  8. moe

    moe Active Member

    I found this very useful

    Hayward S, Zwarteveen J, Landorf K, du Toit V. Pitted keratolysis: a common dermatological condition causing foot malodour. Australasian Journal of Podiatric Medicine 1999; 33(4): 129-132.
  9. ezlington

    ezlington Member

    I had a similar case, but the gent had other symptoms consistent with overactive thyroid which proved to be the case on investigation. Usually its just occupation, activity and footwear.

  10. Peter Norton

    Peter Norton Member

    Hi..i have treated many pitting skin condition involving hyperkerotosis, hyperhydrosis on the plantar aspect of the feet.
    1.debride using scapel'
    2.buff with sanding disc
    3.castellani paint with magenta or KMnO4 or Rock crystal (bromhydrosis) or nonscents
    4.breathable foot wear pref
    5.cushioned orthotics with absorbent washable top cover

    Peter Norton
    Body Clinic
    Jakarta Indonesia
  11. hamish dow

    hamish dow Active Member

    Debride when at its most moist apply Trust ointment as per instructions. Most excelllent stuff it is.

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