Pitting keratolysis (also known as "Keratolysis plantare sulcatum," "Keratoma plantare sulcatum," and "Ringed keratolysis") is an infectious skin infection that can be caused by the use of tight or restricting and excessive footwear. sweating. Infection is characterized by crater-like holes on the surface of the foot and toes, especially the load-bearing areas. Treatment consists of a topical antibiotic application. Complicate Keratolysis is caused by bacteria, which develop in this environment.
This condition is quite common, especially in the military where wet boots/boots are worn for a long time without removing/cleaning. Skin biopsy specimens are usually not used, because the diatomy pyrolysis diagnosis is often done with visual examination and the introduction of distinctive odors. Wood lamp inspection results are inconsistent.
Video Pitted keratolysis
Symptoms
Complicating keratolysis usually presents with many discrete lesions, "hollowed out" or perforated, usually located on the sole of the foot. These circular and shallow holes are characteristic of pitted keratolysis, and often overlap to produce a larger area of ​​erosion. The appearance of the characteristic lesion of this condition becomes more pronounced when the affected area is wet or perforated in water. Sometimes these lesions come in green or brown in and around the hole.
This superficial effect is found under the toes and on the soles of the feet, and especially on pressure-bearing pressure points such as the heel. Usually, both legs are equally influenced. Rarely, this condition affects the palms of the hands. Complicating keratolysis is associated with excessive sweating of the palms of the hands or the soles of the feet (palmoplantar hyperhidrosis.) The digestion of bacteria from keratin produces a very foul odor. Irritation is generally minimal, although occasionally burning, itching, and pain are sometimes experienced with keratolysis pitted.
Maps Pitted keratolysis
Microbiology
The most common cause of keratolysis pitted is the Corynebacterium species. However, some other bacteria can also cause conditions, especially Actinomyces keratolytica, Dermatophilus congolensis, Kytococcus sedentarius, and Streptomyces. Less often, it is due to the species Acinetobacter, Clostridium, Klebsiella, and Pseudomonas.
Risk factors
People of all ages, races, or genders can be victims of this disorder, although more often found in men. People who are sweating or washing tend to tend to complain keratolysis. The use of prolonged occlusive footwear, such as tight shoes or rubber boots, also makes people more vulnerable. Not surprisingly, athletes and soldiers are particularly vulnerable to this problem. Hot and humid weather is another factor to increase risk. Those taking immunosuppressive drug therapy or diabetics are also more likely to succumb to compressed keratolysis.
Differential diagnosis
- Hyperhidrosis
- Erythrasma
- Tinea pedis
Diagnosis
The diagnosis of pitted keratolysis is based primarily on physical examination, with the recognition of classic pitted lesions and pungent odors. Dermoscopic examination can facilitate visualization of holes and pit walls. Wood lamps may show red coral fluorescence, as seen in erythrasma. However, these findings are not uniformly present, as these conditions may be caused by bacteria that do not produce fluorescent pigments. Further laboratory examination is usually not necessary for diagnosis. However, preparation of potassium chloride may help rule out fungal infections. Imaging and biopsy are not needed.
Treatment
Treatment consists primarily of topical antibodies. Effective choices include clindamycin, erythromycin, mupirocin, and fusidic acid. Topical antibiotics are applied to the affected area twice daily, until resolution. Benzoyl peroxide is an effective alternative, which can be used alone, or in addition to antibiotic therapy.
Foot hygiene is important. Feet should be washed at least daily with soap and water, and dried thoroughly afterwards. Absorbent socks, such as cotton, should be worn. Open-toed shoes can help with ventilation and keep the feet dry. Botulinum toxin that reduces hyperhidrosis has helped. Topical hexahydrate aluminum chloride, applied every night can decrease excessive sweating and can improve treatment response for pitted keratolysis.
Complicating keratolysis can be reduced and eventually stops by regularly applying a free amount of antiperspirant body powder to the inside of the shoe and socks of the sufferer. The usual powder application will greatly reduce foot sweat and keep the plantar surface from dry feet thus creating a hostile environment with Corynebacterium.
History
Paulo Labrador Origin Pitted keratolysis was first called "Keratoma plantare sulcatum."
See also
- List of skin conditions
References
Source of the article : Wikipedia
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