Pitted keratolysis: a clinical review

Area of Science:

• Dermatology
• Infectious Diseases
• Podiatry

Background:

• Pitted keratolysis is a bacterial infection impacting the plantar epidermis.
• Limited clinical guidance exists for managing this persistent foot condition.
• The infection affects diverse populations globally, both shod and unshod.

Purpose of the Study:

• To review existing literature on treatments for pitted keratolysis.
• To identify evidence-based management strategies for clinicians.

Main Methods:

• A structured literature search was conducted across multiple databases.
• Papers reporting treatments tested on patients with pitted keratolysis were identified.

Main Results:

• Literature primarily consists of low-level evidence (case reports, small series).
• Topical antibiotics (clindamycin, erythromycin, fusidic acid, mupirocin) are commonly studied, often with hygiene advice and antiperspirants.
• Topical antibiotics show some efficacy, but oral antibiotics alone are not effective.

Conclusions:

• No definitive consensus exists for optimal pitted keratolysis management.
• Combining antimicrobial agents with adjunctive measures like antiperspirants shows promise.
• Further high-quality research is needed to establish best practice guidelines.