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Pitted keratolysis

Discussion in 'General Issues and Discussion Forum' started by NewsBot, Mar 29, 2006.

  1. NewsBot

    NewsBot The Admin that posts the news.


    Members do not see these Ads. Sign Up.
    The Indian J Dermatol Venereol Leprol has a good free full text article on pitted keratolysis:
    Full article
  2. DaVinci

    DaVinci Well-Known Member

  3. Admin2

    Admin2 Administrator Staff Member

  4. twirly

    twirly Well-Known Member


    Response to an old thread (sorry). I only joined the Arena recently. :)

    I felt I had to thank you for the wonderful link you posted: see below.

    A plethora of pictures, slides & information at my fingertips.

    Well worth a look

    Once again, thanks.

    Regards :drinks
  5. Rudcenko

    Rudcenko Welcome New Poster

    To Da Vinci
    I wish to say thank you for the picture google link. Brilliant and very good to see such a variety of the same condition. Thank you :)
    Mostly they mention antibiotic treatment, I assume that is in the US, what do people do in the UK?
    Hana Rudcenko
    Cheam Chiropody Clinic
    SM3 8BU
  6. MR NAKE

    MR NAKE Active Member

    i believe they left out fungal involvement, and in uk i would do a full course of antibiotics as well as antifungals, anxiolytics are also encouraged in generalised hyperhydrosis. formalin soaks. KMNO4, (ASTRINGENTS!!!!)
  7. MR NAKE

    MR NAKE Active Member

  8. pgcarter

    pgcarter Well-Known Member

    Formalin and its formaldehyde cousin is out now....declared carcinogenic here
    regards Phill
  9. RussAgg

    RussAgg Active Member

    I had a rather nasty case myself a few summers ago. I did consider asking my GP for topical Clindamycin but opted for 'neat' tea tree oil (Thursday plantation) instead and it worked a treat.
  10. Have had amazing results with 3% salicylic acid in spirit used daily for 4 weeks, two times week for 4 weeks, then weekly for 4 weeks, then fortnightly thereafter. Great on really smelly feet too.
  11. Reidworld20

    Reidworld20 Welcome New Poster

    First post to Podiatry arena.... so please be gentle.

    I have a patient with nasty pitted keratolysis, will post photos if people want.
    He says he has "tried everything" but I am keen to write to GP and ask for a topical antibiotic prescription.
    However, re the salicylic acid treatment, is this an OTC product or does it need a prescription too?

  12. Sorry for late reply, don't get on much. The sal acid is available OTC but the pharmacist likes to receive it on a bit of letter head for some reason. I print up the whole treatment regime onto letterhead for them to take that in. Good luck with it. It works amazingly.
  13. kc

    kc Member

    wow - everyone is really hitting the hard stuff to treat this!
    My son had a decent case of this and it responded to a lovely old faishoned cure-
    i had him wash his feet straight after school, soak his feet in a weak soultion of Condy's crystals -potassium permanganate- for 5 minutes, then rub in Whitfields ointment.It was very easy and effective.
  14. hamish dow

    hamish dow Active Member

    TRUST, quite possibly the best product I have come across and a good hard look at personal hygiene and footwer and its fit.
  15. Reidworld20

    Reidworld20 Welcome New Poster

    Hi, my patient was despatched to local pharmacist with clear instructions on letter headed paper. Pharmacist actually dispensed "Whifield's" ointment which seems to be a mix of Benzoic acid & salycylic acid. Am pleased to report all symptoms cleared and a very happy patient! Thanks again for the advice.
  16. hamish dow

    hamish dow Active Member

  17. NewsBot

    NewsBot The Admin that posts the news.

    Plantar pitted keratolysis: a study from non-risk groups
    Asli Feride Kaptanoglu, Ozlem Yuksel, Selcuk Ozyurt
    Dermatology Reports Vol 4, No 1 (2012)
  18. SDBizz

    SDBizz Member

    I've read through the posts on PK but feel I still need some help/advice.

    My sons (16 yrs old) feet suffer with hyperhidrosis at the best of times but this wasn't helped after a soggy trekking weekend in October.

    He wears the same school shoes each day (I know I should buy a second pair) and then changes into his trainers and/or running spikes (400m sprint runner - plenty of friction going on).

    By the end of November it seemed clear he had a widespread case of PK on both feet. Punched out hole/small crater effects and the smell was horrendous! So antibacterial soap and a good scrub. Dedicated foot towel, washed regularly and antibacterial cream (mupirocin) applied twice a day.

    The smell seemed to go quite quickly and his feet started to look alot better. However by the end of January it still hadn't cleared up fully and his foot hygiene and application of antibacterial cream was meticulous.

    So he took a course of erythromycin oral antibiotics to surely see an end to this.

    It's now March and I still can't get rid of it. I'm now just trying out the neat tea tree oil option and now doubt my diagnosis as nothing has worked. Please see the photo attached of what the condition looks like now.

    The pits seem to be getting deeper and he only told me today that they feel sore first thing in the morning. What else can I do? Go back to using the antibacterial cream?

    Please help!

    Thanks, Sara

    Attached Files:

  19. Heather J Bassett

    Heather J Bassett Well-Known Member

    Have not read the other posts but BAMBOO SILVER SOCKS?

  20. blinda

    blinda MVP

    Hi Sara,

    First of all your diagnosis is spot on, judging by your description and pics. However, anti-bacterial Mupirocin cream alone may not be man enough to tackle this as it is only bacteriostatic (prevents bacterial reproduction) at low concentrations, which most creams are, and bactericidal (destroys the bacteria) at high concentrations. I would recommend topical anti-biotic, not anti-bacterial, medication. PK is a superficial bacterial infection so a topical application of clindamycin and erythromycin has been evidenced as both safe and effective (as seen in the previous posts on this thread).

    Before seeking the advice of a podiatrist, several of my patients reported worsening of the infection after application of over the counter products as these contain anti-bacterials, anti-fungals and anti-perspirants yet utilise an ointment as an application vehicle which often aggravates maceration and hyperhydrosis! I often recommend application of Fusidic acid (see here) lotion, along with the usual advice (see here) of allowing shoes to dry out, avoiding occlusion, etc.

    Now, I`m not going to say much about the use of Tea Tree Oil other than....why? ;)

  21. David Smith

    David Smith Well-Known Member


    5 minute Potassium permanganate foot baths and clotrimazole 1% both applied daily for one month and some debridement when possible and appropriate has never failed for any patient I have seen with this condition.

    Dave Smith
  22. SDBizz

    SDBizz Member

    Thanks all for your advice and suggestions. Shortly after my post I took him to see a dermatologist as I'd been unable to track down any erythromycin in a ready made preparation. I was sent away with a prescription for a solution containing the following:

    Erythromycin base 5,0 ml
    Isopropyl alcohol 65,0 ml
    Propylene glycol 15,0 ml
    Aqua pur 15,0 ml
    To be applied 2 x per day for 3 months

    Along with Lomexin spray (fenticonazole nitrate)

    So hopefully he'll see some positive results soon.

    Thanks again, Sara
  23. blinda

    blinda MVP

    Thanks for the update, Sara. Please do inform us of his progress...with pics ;)

  24. I've had a few of these lately. Being as I am a bit of a dermaclot, I've been treating them with twice daily application of surgical spirit to dry the skin followed by a liberal application of Betadine dry powder spray (for the environment and the antimicrobial respectively). I do love Iodine, not least because its brown.

    Nobody else has mentioned using dry powder betadine, anyone else tried it?
  25. Jose Antonio Teatino

    Jose Antonio Teatino Well-Known Member


    Attached Files:

  26. Rudcenko

    Rudcenko Welcome New Poster

  27. NewsBot

    NewsBot The Admin that posts the news.

    Pitted keratolysis; physicians’ treatment and their perceptions in Dutch army personnel
    E.M. van der Snoek1, M.B. Ekkelenkamp, J.C.C.W. Suykerbuyk
    Journal of the European Academy of Dermatology and Venereology; Article first published online
  28. NewsBot

    NewsBot The Admin that posts the news.

    Pitted keratolysis, erythromycin, and hyperhidrosis
    Guglielmo Pranteda et al
    Dermatologic Therapy; Early View
  29. Blarney

    Blarney Active Member

  30. NewsBot

    NewsBot The Admin that posts the news.

    Pitted Keratolysis
    A Clinical Review
    Ivan R. Bristow , PhD and Yong Leng H. Lee , BSc(Hons)
    Journal of the American Podiatric Medical Association: March 2014, Vol. 104, No. 2, pp. 177-182.
  31. beckringrose

    beckringrose Member

    Just wondering what pods in Australia are using for PK? I have a client with the nastiest case of it I have seen. Potassium Permanganate crystals helped initially but haven't cured it. Unfortuantely he works on a farm in boots all day.
    What's the best OTC remedy or is there something better on prescription? I need something that will blast it away permanently!
    He now also has a lot of pain. Is this common with PK?
    It is 6 months since I have seen him (I hoped the absence meant he was cured) and I can get pictures at his appointment next week.
  32. NewsBot

    NewsBot The Admin that posts the news.

    Emergent pitted keratolysis in the Andes Cusco-Per?
    Garc?a CGR, Figueroa NYM, Arrese EJ
  33. NewsBot

    NewsBot The Admin that posts the news.

    Pitted keratolysis
    Hiram Larangeira de Almeida Jr et al
    An Bras Dermatol. 2016 Jan-Feb; 91(1): 106–108.
  34. NewsBot

    NewsBot The Admin that posts the news.

    Pitted keratolysis: successful management with mupirocin 2% ointment monotherapy.
    Greywal T, Cohen PR.
    Dermatol Online J. 2015 Aug 15;21(8). pii: 13030/
  35. NewsBot

    NewsBot The Admin that posts the news.

  36. NewsBot

    NewsBot The Admin that posts the news.

    Pitted keratolysis – a study of various clinical manifestations
    Meena Makhecha et al
    Int J Derm; 18 September 2017

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