Pitted Keratolysis

This 8-year-old boy's mother thought her son had a fungal infection on his feet. Examination disclosed malodorous, nontender plaque formation on the weight-bearing surfaces of both feet. Within the plaques were round pits and furrows. A diagnosis of pitted keratolysis was made. The lesions cleared rapidly with the use of topical erythromycin.

Pitted keratolysis is a relatively common bacterial infection, and its unique appearance facilitates clinical diagnosis. Its is caused by Corynebacterium, Dermatophilus congolensis, or Micrococcus sedentarius, and it responds rapidly to topical erythromycin, clindamycin, or benzoyl peroxide.