Keratoma sulcatum

Last Updated: 2022-07-22

Author(s): Anzengruber F., Navarini A.

ICD11: 1C44

Castellani, 1910

Plantar pitting, pitted keratolysis, dimpled keratolysis, ringed keratolysis, keratoma plantaris sulcatum.

Dimpled corneal defects on the stressed areas of the soles of the feet.

  • Occurring worldwide
  • Frequently seen in men
  • Sneaker wearers are particularly affected
  • Rarely occurring in patients >50 years
  • Very common in tropical and subtropical climates
  • The disease does not occur in cold climates and is not observed in barefoot people in dry climates
  • Frequent association with erythema sulcatum and erythrasma

  • Involved:
    • Corynebacteria, Micrococcus sedentarius, Dermatophilus congolensis, Actinomyces spp
  • The development is mainly favoured by hyperhidrosis and occlusive footwear. In a warm and humid environment, there is a proliferation of bacteria that occur in the normal skin flora. Damage to the horny layer and enzymatic activity of proteases and keratinases lead to the formation of shallow dimples

  • Whitish skin-coloured, as if punched out, circine dimples on the pressure-loaded areas of the sole of the foot. No or little pressure pain, but patients sometimes report pain when walking
  • Mostly foetid odour (bromidrosis) and hyperhidrosis

Soles of the feet, especially the pressure-loaded areas.

Urbital defects of the str. corneum. Sometimes bacteria can be detected.

If milieu factors can be eliminated favourably, otherwise there is a risk of a chronic course.

  • Remediation of the triggers
  • Treatment of the hyperhidrosis
  • Regular washing of the feet with disinfecting solutions
  • Hygiene measures!
  • No occluding footwear, wear breathable shoes
  • Erythromycin cream 2-3 times a day
  • Clindamycin cream 2-3 times a day
  • Clotrimazole cream 2-3 times a day
  • Benzoyl peroxide as cream, gel or solution once daily

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