Pitted keratolysis is a non-inflammatory superficial gram positive bacterial infection of the palms and soles, although the latter is most common. Clinically, pitted keratolysis is characterized by small depressions or pits in the top layer of the skin. These pits are typically asymptomatic but can itch or become tender. The species of Corynebacterium and Actinomyces are typically the causative agents.
Although pitted keratolysis is frequently associated with excessive sweating and a foul smell, it is not caused solely by the excessive sweating. Rather, perspiration along with tight clothing like socks creates an environment for the bacteria to grow.
Treatment includes avoiding tight fitting socks and shoes. Additionally, prescription strength anti-bacterial gels or creams such as clindamycin, erythromycin or mupirocin can be helpful. Sometimes a physician will also prescribe a drying agent such as Drysol.
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