Home Forums Marketplace Table of Contents Events Member List Site Map Register Mark Forums Read



Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

If you have any problems with the registration process or your account login, please contact contact us.


Tags: , ,

Pitted keratolysis

Reply
Submit Thread >  Submit to Digg Submit to Reddit Submit to Furl Submit to Del.icio.us Submit to Google Submit to Yahoo! This Submit to Technorati Submit to StumbleUpon Submit to Spurl Submit to Netscape  < Submit Thread
 
Thread Tools Display Modes
  #1  
Old 29th March 2006, 01:28 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 13,579
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 14
Thanked 584 Times in 474 Posts
Default Pitted keratolysis

Podiatry Arena members do not see these ads
The Indian J Dermatol Venereol Leprol has a good free full text article on pitted keratolysis:
Quote:
Singh G, Naik CL. Pitted keratolysis. Indian J Dermatol Venereol Leprol [serial online] 2005 [cited 2006 Mar 29];71:213-215. Available from: http://www.ijdvl.com/article.asp?iss...5;aulast=Singh
Quote:
The Corynebacteria are a diverse group of gram-positive bacilli which include Corynebacterium diphtheriae as well as a bewildering number of species that are found on the skin as part of the normal flora. These latter organisms are usually referred to as diphtheroids or coryneforms. Three skin conditions appear to be related to an overabundance of these coryneforms: pitted keratolysis, erythrasma, trichomycosis. Interestingly, all three have been reported to coexist in the same person.

Pitted keratolysis is an acquired, chronic, usually asymptomatic, non-inflammatory, superficial bacterial infection of the skin, confined to the stratum corneum of the soles, characterized clinically by multifocal, discrete, superficial crateriform pits and superficial erosions. It can rarely occur on the palms.
Quote:
Prevention and Treatment

Various preventive measures recommended are, avoiding use of occlusive footwear, reduction of foot friction with properly fitting footwear, using absorbent cotton socks, wearing open toed sandals whenever possible, washing feet with soap or antibacterial cleanser twice a day, and avoiding sharing of footwear or towels. In some cases it may be helpful to reduce any associated hyperhidrosis with the application of a roll-on antiperspirant or 20% aluminum chloride solution.[8]

Topical antibiotics are effective, easy to use and accepted by patients. Recommendations include twice daily application of erythromycin[16] solution or gel, 1% clindamycin hydrochloride solution,[19] fusidic acid cream and mupirocin cream.[8]

Various other medications, like 0.1% triamcinolone acetonide, iodochlorhydroxyquin-hydrocortisone cream, flexible collodion, benzoic and salicylic acid ointment, 2% buffered glutaraldehyde,[20] Castellani's paint, gentamicin sulphate cream,[21] 1% clotrimazole cream, 2% miconazole nitrate cream, 1% clindamycin solution, 5% formalin solution and Whitfield's ointment[22] have been used with limited success. Success has also been reported with oral erythromycin therapy.[16] Pitted keratolysis has an excellent prognosis; effective treatment clears both the lesion and the odor in 3-4 weeks.
Full article
Reply With Quote
The Following 5 Users Say Thank You to NewsBot For This Useful Post:
carolethecatlover (27th August 2010), Christelle Slabber (22nd August 2010), Kaleidoscope (10th February 2012), Mankgabane (17th January 2010), Rudcenko (18th April 2012)
Sponsored Links
  #2  
Old 29th March 2006, 02:49 PM
DaVinci's Avatar
DaVinci DaVinci is offline
Podiatry Arena Veteran
 
About:
Join Date: Jan 2006
Location: Australia
Posts: 633
Join Date: Jan 2006
Marketplace reputation 0% (0)
Thanks: 97
Thanked 53 Times in 38 Posts
Default

I did a Google search for this just the other day.

eMedicine has a good article on it:
http://www.emedicine.com/derm/topic332.htm

A Google image search turned up lots of good pictures:
http://images.google.com/images?svnu...ysis&spell= 1
Reply With Quote
The Following 3 Users Say Thank You to DaVinci For This Useful Post:
Jose Antonio Teatino (13th August 2012), Rudcenko (18th April 2012), waddis (26th January 2010)
  #3  
Old 2nd April 2006, 06:57 AM
Admin2's Avatar
Admin2 Admin2 is offline
Administrator
 
About:
Join Date: May 2005
Location: Cyberspace
Posts: 3,887
Join Date: May 2005
Marketplace reputation 0% (0)
Thanks: 15
Thanked 139 Times in 123 Posts
Default

There was also this thread:
Pits on sole of foot - whats your diagnosis?
Reply With Quote
  #4  
Old 13th December 2007, 06:17 AM
twirly's Avatar
twirly twirly is offline
Podiatry Arena Veteran
Welcome Committee
 
About:
Join Date: Oct 2007
Location: South Yorkshire. UK
Posts: 1,658
Join Date: Oct 2007
Marketplace reputation 0% (0)
Thanks: 1,154
Thanked 309 Times in 220 Posts
Thumbs up Re: Pitted keratolysis

DaVinci,

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.

Quote:
Originally Posted by DaVinci View Post
I did a Google search for this just the other day.

eMedicine has a good article on it:
http://www.emedicine.com/derm/topic332.htm

A Google image search turned up lots of good pictures:
http://images.google.com/images?svnu...ysis&spell= 1
A plethora of pictures, slides & information at my fingertips.

Well worth a look

Once again, thanks.

Regards
__________________
:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”
Reply With Quote
  #5  
Old 10th June 2009, 06:36 AM
Rudcenko Rudcenko is offline
Podiatry Arena Rookie
 
About:
Join Date: Jan 2006
Location: Cheam, Surrey
Posts: 2
Join Date: Jan 2006
Marketplace reputation 0% (0)
Thanks: 4
Thanked 0 Times in 0 Posts
Default Re: Pitted keratolysis

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
Reply With Quote
  #6  
Old 6th November 2009, 05:10 AM
MR NAKE MR NAKE is offline
Senior Member
 
About:
Join Date: Apr 2009
Location: paradise
Posts: 60
Join Date: Apr 2009
Marketplace reputation 0% (0)
Thanks: 84
Thanked 2 Times in 2 Posts
Default Re: Pitted keratolysis

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!!!!)
Reply With Quote
The Following User Says Thank You to MR NAKE For This Useful Post:
Rudcenko (6th November 2009)
  #7  
Old 6th November 2009, 05:26 AM
MR NAKE MR NAKE is offline
Senior Member
 
About:
Join Date: Apr 2009
Location: paradise
Posts: 60
Join Date: Apr 2009
Marketplace reputation 0% (0)
Thanks: 84
Thanked 2 Times in 2 Posts
Default Re: Pitted keratolysis

http://www.ncbi.nlm.nih.gov/bookshel...med&part=A5272
http://www.mobipocket.com/EN/eBooks/...p?BookID=34189
Reply With Quote
  #8  
Old 11th November 2009, 02:36 PM
pgcarter pgcarter is offline
Podiatry Arena Veteran
 
About:
Join Date: Oct 2004
Location: Bairnsdale
Posts: 494
Join Date: Oct 2004
Marketplace reputation 0% (0)
Thanks: 0
Thanked 36 Times in 33 Posts
Default Re: Pitted keratolysis

Formalin and its formaldehyde cousin is out now....declared carcinogenic here
regards Phill
Reply With Quote
  #9  
Old 20th November 2009, 07:39 AM
RussAgg's Avatar
RussAgg RussAgg is offline
Member
 
About:
Join Date: Mar 2007
Location: Exeter, UK
Posts: 27
Join Date: Mar 2007
Marketplace reputation 0% (0)
Thanks: 0
Thanked 3 Times in 3 Posts
Default Re: Pitted keratolysis

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.
Reply With Quote
  #10  
Old 29th November 2009, 05:11 AM
Nicole Murphy (Avard) Nicole Murphy (Avard) is offline
Member
 
About:
Join Date: Sep 2007
Posts: 5
Join Date: Sep 2007
Marketplace reputation 0% (0)
Thanks: 0
Thanked 2 Times in 1 Post
Default Re: Pitted keratolysis

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.
Reply With Quote
  #11  
Old 1st January 2010, 08:16 AM
Reidworld20 Reidworld20 is offline
Podiatry Arena Rookie
 
About:
Join Date: May 2009
Posts: 3
Join Date: May 2009
Marketplace reputation 0% (0)
Thanks: 6
Thanked 0 Times in 0 Posts
Smile Re: Pitted keratolysis

Quote:
Originally Posted by Nicole Murphy (Avard) View Post
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.
Hi,
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?

Thanks...
Reply With Quote
  #12  
Old 10th January 2010, 05:27 AM
Nicole Murphy (Avard) Nicole Murphy (Avard) is offline
Member
 
About:
Join Date: Sep 2007
Posts: 5
Join Date: Sep 2007
Marketplace reputation 0% (0)
Thanks: 0
Thanked 2 Times in 1 Post
Default Re: Pitted keratolysis

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.
Reply With Quote
The Following 2 Users Say Thank You to Nicole Murphy (Avard) For This Useful Post:
carolethecatlover (27th August 2010), Reidworld20 (29th January 2010)
  #13  
Old 15th January 2010, 09:53 PM
kc kc is offline
Member
 
About:
Join Date: Oct 2009
Location: Melbourne
Posts: 13
Join Date: Oct 2009
Marketplace reputation 0% (0)
Thanks: 5
Thanked 5 Times in 2 Posts
Default Re: Pitted keratolysis

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.
Reply With Quote
The Following 4 Users Say Thank You to kc For This Useful Post:
carolethecatlover (27th August 2010), Christelle Slabber (22nd August 2010), Jose Antonio Teatino (13th August 2012), Reidworld20 (29th January 2010)
  #14  
Old 20th January 2010, 01:04 AM
hamish dow hamish dow is offline
Senior Member
 
About:
Join Date: Sep 2009
Location: newcastle upon tyne
Posts: 113
Join Date: Sep 2009
Marketplace reputation 0% (0)
Thanks: 7
Thanked 12 Times in 11 Posts
Default Re: Pitted keratolysis

TRUST, quite possibly the best product I have come across and a good hard look at personal hygiene and footwer and its fit.
Reply With Quote
  #15  
Old 16th August 2010, 08:01 AM
Reidworld20 Reidworld20 is offline
Podiatry Arena Rookie
 
About:
Join Date: May 2009
Posts: 3
Join Date: May 2009
Marketplace reputation 0% (0)
Thanks: 6
Thanked 0 Times in 0 Posts
Default Re: Pitted keratolysis

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.
Reply With Quote
  #16  
Old 18th August 2010, 03:45 AM
hamish dow hamish dow is offline
Senior Member
 
About:
Join Date: Sep 2009
Location: newcastle upon tyne
Posts: 113
Join Date: Sep 2009
Marketplace reputation 0% (0)
Thanks: 7
Thanked 12 Times in 11 Posts
Default Re: Pitted keratolysis

Whitfield's ung? must be some still left over from The Arc. See the old stuff still has benefit
Trust is tricky to get a good link to, we order it in from our supplier, but these links might help.
http://www.trustproducts.co.uk/acata...eshopping.html
http://www.yourhealthfoodstore.co.uk...long-life-foot
Reply With Quote
The Following User Says Thank You to hamish dow For This Useful Post:
twirly (18th August 2010)
  #17  
Old 8th February 2012, 09:42 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 13,579
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 14
Thanked 584 Times in 474 Posts
Default Re: Pitted keratolysis

Plantar pitted keratolysis: a study from non-risk groups
Asli Feride Kaptanoglu, Ozlem Yuksel, Selcuk Ozyurt
Dermatology Reports Vol 4, No 1 (2012)
Quote:
Pitted keratolysis is an acquired, superficial bacterial infection of the skin which is characterized by typical malodor and pits in the hyperkeratotic areas of the soles. It is more common in barefooted people in tropical areas, or those who have to wear occlusive shoes, such as soldiers, sailors and athletes. In this study, we evaluated 41 patients who had been diagnosed with plantar pitted keratolysis. The patients were of high socioeconomic status, were office-workers, and most had a university degree. Malodor and plantar hyperhydrosis were the most frequently reported symptoms. The weight-bearing metatarsal parts of the feet were those most affected. Almost half the women in the study gave a history of regular pedicure and foot care in a spa salon. Mean treatment duration was 19 days. All patients were informed about the etiology of the disease, predisposing factors and preventive methods. Recurrences were observed in only 17% of patients during the one year follow-up period. This study emphasizes that even malodorous feet among non-risk city dwellers may be a sign of plantar pitted keratolysis. A study of the real incidence of the disease in a large population-based series is needed.
Thread Starter
Reply With Quote
  #18  
Old 21st March 2012, 02:22 PM
SDBizz SDBizz is offline
Member
 
About:
Join Date: Feb 2012
Location: Greece
Posts: 15
Join Date: Feb 2012
Marketplace reputation 0% (0)
Thanks: 1
Thanked 1 Time in 1 Post
Default Re: Pitted keratolysis

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 Images
File Type: jpg DSC08520 (Custom).JPG (18.9 KB, 277 views)
Reply With Quote
  #19  
Old 25th March 2012, 03:54 AM
Heather J Heather J is offline
Podiatry Arena Veteran
Welcome Committee
 
About:
Join Date: Feb 2006
Posts: 1,012
Join Date: Feb 2006
Marketplace reputation 0% (0)
Thanks: 508
Thanked 66 Times in 64 Posts
Default Re: Pitted keratolysis

Have not read the other posts but BAMBOO SILVER SOCKS?

Cheers
__________________
Heather J Bassett
137 Wheatsheaf Road
GLENROY VICTORIA 3046
AUSTRALIA
03 9306 8557
Reply With Quote
  #20  
Old 25th March 2012, 07:17 AM
blinda's Avatar
blinda blinda is offline
Podiatry Arena Veteran
 
About:
Join Date: Feb 2008
Posts: 2,172
Join Date: Feb 2008
Marketplace reputation 0% (0)
Thanks: 797
Thanked 892 Times in 517 Posts
Default Re: Pitted keratolysis

Quote:
Originally Posted by SDBizz View Post
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
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?

Cheers,
Bel
__________________
Belinda Longhurst
Reply With Quote
The Following 4 Users Say Thank You to blinda For This Useful Post:
DaveJames (19th April 2012), Kaleidoscope (15th April 2012), mej.gillies (26th March 2012), twirly (25th March 2012)
  #21  
Old 26th March 2012, 11:10 AM
David Smith's Avatar
David Smith David Smith is offline
Podiatry Arena Veteran
 
About:
Join Date: Oct 2004
Posts: 1,791
Join Date: Oct 2004
Marketplace reputation 0% (0)
Thanks: 138
Thanked 358 Times in 244 Posts
Default Re: Pitted keratolysis

Quote:
Originally Posted by SDBizz View Post
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
Sara

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
__________________
Descartes seems to consider here that beliefs formed by pure reasoning are less doubtful than those formed through perception.
Reply With Quote
  #22  
Old 12th April 2012, 09:34 AM
SDBizz SDBizz is offline
Member
 
About:
Join Date: Feb 2012
Location: Greece
Posts: 15
Join Date: Feb 2012
Marketplace reputation 0% (0)
Thanks: 1
Thanked 1 Time in 1 Post
Default Re: Pitted keratolysis

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
Reply With Quote
The Following User Says Thank You to SDBizz For This Useful Post:
twirly (14th April 2012)
  #23  
Old 12th April 2012, 09:36 AM
blinda's Avatar
blinda blinda is offline
Podiatry Arena Veteran
 
About:
Join Date: Feb 2008
Posts: 2,172
Join Date: Feb 2008
Marketplace reputation 0% (0)
Thanks: 797
Thanked 892 Times in 517 Posts
Default Re: Pitted keratolysis

Quote:
Originally Posted by SDBizz View Post
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
Thanks for the update, Sara. Please do inform us of his progress...with pics

Cheers,
Bel
__________________
Belinda Longhurst
Reply With Quote
  #24  
Old 13th April 2012, 12:34 AM
Robertisaacs's Avatar
Robertisaacs Robertisaacs is offline
Podiatry Arena Veteran
 
About:
Join Date: May 2006
Location: Kent
Posts: 4,290
Join Date: May 2006
Marketplace reputation 0% (0)
Thanks: 454
Thanked 910 Times in 526 Posts
Default Re: Pitted keratolysis

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?
__________________
Robert Isaacs
Specialist in Biomechanical Therapies

small, yellow, leech-like, and probably the oddest thing in the universe

Semper in excretum sum sed alta variat

The opinions expressed are those of the author.
Reply With Quote
  #25  
Old 14th April 2012, 06:15 PM
Jose Antonio Teatino's Avatar
Jose Antonio Teatino Jose Antonio Teatino is offline
Podiatry Arena Veteran
 
About:
Join Date: Apr 2007
Location: Albacete(España)
Posts: 450
Join Date: Apr 2007
Marketplace reputation 0% (0)
Thanks: 101
Thanked 82 Times in 66 Posts
Default Re: Pitted keratolysis

Picture
Attached Images
File Type: jpg Queratolisis punctata.jpg (271.1 KB, 209 views)
Reply With Quote
  #26  
Old 18th April 2012, 06:37 AM
Rudcenko Rudcenko is offline
Podiatry Arena Rookie
 
About:
Join Date: Jan 2006
Location: Cheam, Surrey
Posts: 2
Join Date: Jan 2006
Marketplace reputation 0% (0)
Thanks: 4
Thanked 0 Times in 0 Posts
Default

Quote:
Originally Posted by DaVinci View Post
I did a Google search for this just the other day.

eMedicine has a good article on it:
http://www.emedicine.com/derm/topic332.htm

A Google image search turned up lots of good pictures:
http://images.google.com/images?svnu...ysis&spell= 1
Just to say big thank you for the above info. I found the pictures very helpful.
Sorry with the late thanks
Hana Rudcenko
Reply With Quote
  #27  
Old 12th August 2012, 08:52 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 13,579
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 14
Thanked 584 Times in 474 Posts
Default Re: Pitted keratolysis

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
Quote:
Background  Pitted keratolysis (PK) is a common plantar skin manifestation in army personnel, farmers and athletes. Due to pain while walking and marching, the condition can cause reduced operational deployability (in case of army personnel).

Objective  We used a questionnaire to investigate currently used treatment options of PK and perceptions on perceived efficacy of these treatments among Royal Netherlands Armed Forces primary health care physicians.

Methods  A cross-sectional anonymous postal questionnaire survey was conducted among all Royal Netherlands Armed Forces primary health care physicians. In addition to question about prescription behaviour on the treatment of PK by topical and oral therapies and given non-pharmacological treatment, several questions assessed perceived efficacy of these therapies.

Results  Of the 164 eligible primary health care physicians, 51 (31.1%) completed the questionnaire. Half of physicians had seen less than five patients with PK in the preceding year. Two-thirds of physicians reported problems with operational deployability in less than 10% of army personnel with PK. PK was treated mostly with topical and non-pharmacological treatments. Oral therapy was seldom prescribed. For hyperhidrosis, aluminium chloride hexahydrate was used in most cases.

Conclusion  PK and related reduced operational deployability were less often reported than expected in this study. Dutch physicians prefer combined topical antibiotic therapy with non-pharmacological treatments and perceive the efficacy of topical antibiotic therapy superior to non-pharmacological treatments. Preventive measures, topical antibiotic therapy and adequate treatment of hyperhidrosis are the mainstay methods in the management of patients with PK.
Thread Starter
Reply With Quote
  #28  
Old 29th May 2013, 08:53 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 13,579
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 14
Thanked 584 Times in 474 Posts
Default Re: Pitted keratolysis

Pitted keratolysis, erythromycin, and hyperhidrosis
Guglielmo Pranteda et al
Dermatologic Therapy; Early View
Quote:
Pitted keratolysis (PK) is a plantar skin disorder mainly caused by coryneform bacteria. A common treatment consists of the topical use of erythromycin. Hyperhidrosis is considered a predisposing factor for bacterial proliferation and, consequently, for the onset of PK. The aim of this study was to evaluate the relationship between PK erythromycin and hyperhidrosis. All patients with PK seen in Sant'Andrea Hospital, between January 2009 and December 2011, were collected. PK was clinically and microscopically diagnosed. All patients underwent only topical treatment with erythromycin 3% gel twice daily. At the beginning of the study and after 5 and 10 days of treatment, a clinical evaluation and a gravimetric measurement of plantar sweating were assessed. A total of 97 patients were diagnosed as PK and were included in the study. Gravimetric measurements showed that in 94 of 97 examined patients (96.90%) at the time of the diagnosis, there was a bilateral excessive sweating occurring specifically in the areas affected by PK. After 10 days of antibiotic therapy, hyperhidrosis regressed together with the clinical manifestations. According to these data, we hypothesize that hyperhidrosis is due to an eccrine sweat gland hyperfunction, probably secondary to bacterial infection.
Thread Starter
Reply With Quote
  #29  
Old 30th May 2013, 12:43 PM
Blarney's Avatar
Blarney Blarney is offline
Member
 
About:
Join Date: Feb 2006
Location: Dublin, Ireland
Posts: 28
Join Date: Feb 2006
Marketplace reputation 0% (0)
Thanks: 0
Thanked 0 Times in 0 Posts
Default Re: Pitted keratolysis

Peditech - spray on after washing - clears in about 7 to 10 days.

http://www.boots.com/en/Peditech-Act...upply_1049070/

Use as required to keep away - less messy time consuming to use than Trust.

Or Trust; http://www.trustproducts.co.uk/

Justin
Podiatry.ie
Reply With Quote
  #30  
Old 3rd April 2014, 06:27 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 13,579
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 14
Thanked 584 Times in 474 Posts
Default Re: Pitted keratolysis

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.
Quote:
Background: Pitted keratolysis is a bacterial infection that affects the plantar epidermis. Despite the condition being reported in many countries affecting both shod and unshod populations, there is little guidance for clinicians providing evidence or best practice guidelines on the management of this often stubborn infection.

Methods: Using a structured search of a range of databases, papers were identified that reported treatments tested on patients with the condition.

Results: Most of the literature uncovered was generally of a low level, such as case-based reporting or small case series. Studies were focused mainly on the use of topical antibiotic agents, such as clindamycin, erythromycin, fusidic acid, and mupirocin, often in combination with other measures, such as hygiene advice and the use of antiperspirants. From the limited evidence available, the use of topical antibiotic agents shows some efficacy in the treatment of pitted keratolysis. However, there is currently no suggestion that oral antibiotic drug therapy alone is effective in managing the condition.

Conclusions: Currently, there is no consensus on the most effective approach to managing pitted keratolysis, but a combination of antimicrobial agents and adjunctive measures, such as antiperspirants, seems to demonstrate the most effective approach from the current literature available.
Thread Starter
Reply With Quote
Reply



Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts
vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Translate This Page


New To Site? Need Help?

Finding your way around:

Browse the forums.

Search the site.

Browse the tags.

Search the tags.


All times are GMT -7. The time now is 08:05 AM.