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Pitted keratolysis, erythromycin, and hyperhidrosis.

Guglielmo Pranteda1, Marta Carlesimo, Giulia Pranteda

  • 1Dermatology Unit, NESMOS Department, Faculty of Medicine and Psychology "Sapienza" University Rome "S. Andrea Hospital,", Rome, Italy.

Dermatologic Therapy
|April 8, 2014
PubMed
Summary

Pitted keratolysis (PK), a bacterial foot condition, is often linked to excessive sweating (hyperhidrosis). Topical erythromycin treatment for PK also resolved hyperhidrosis, suggesting a bacterial cause for the sweating.

Keywords:
eccrine sweat glandshyperhidrosispitted keratolysis

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Area of Science:

  • Dermatology
  • Microbiology

Background:

  • Pitted keratolysis (PK) is a plantar skin condition primarily caused by coryneform bacteria.
  • Hyperhidrosis (excessive sweating) is a known predisposing factor for bacterial infections, including PK.
  • Topical erythromycin is a common treatment for PK.

Purpose of the Study:

  • To investigate the relationship between Pitted Keratolysis (PK), topical erythromycin treatment, and hyperhidrosis.
  • To determine if hyperhidrosis is a cause or consequence of PK.

Main Methods:

  • Clinical and microscopic diagnosis of PK in 97 patients.
  • Patients received topical erythromycin 3% gel twice daily.
  • Plantar sweating was measured gravimetrically at baseline and after 5 and 10 days of treatment.

Main Results:

  • 96.90% of PK patients exhibited excessive plantar sweating in affected areas.
  • Hyperhidrosis significantly regressed in conjunction with PK clinical manifestations after 10 days of erythromycin therapy.
  • The study observed a strong correlation between PK, hyperhidrosis, and bacterial infection.

Conclusions:

  • Hyperhidrosis in PK patients appears to be secondary to bacterial infection, likely due to eccrine sweat gland hyperfunction.
  • Topical erythromycin effectively treats both PK and associated hyperhidrosis.
  • These findings suggest a novel understanding of hyperhidrosis pathogenesis in the context of bacterial skin infections.