Pitted keratolysis in Child
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Synopsis

Pitted keratolysis (also known as keratoma plantare sulcatum and ringed keratolysis) is a noninflammatory bacterial infection of the plantar stratum corneum caused by any of the following bacteria: Kytococcus sedentarius (formerly Micrococcus sedentarius), Dermatophilus congolensis, or species of Corynebacterium or Actinomyces.
Affected areas are generally asymptomatic but can emit a foul odor due to the production of isovaleric acid by the bacterial metabolism of the leucine in sweat. Rarely, pruritus, pain, or burning may be present. Predisposing factors are excessive sweating and prolonged occlusion in a warm, humid environment. Although rare, the hands may be affected.
Affected areas are generally asymptomatic but can emit a foul odor due to the production of isovaleric acid by the bacterial metabolism of the leucine in sweat. Rarely, pruritus, pain, or burning may be present. Predisposing factors are excessive sweating and prolonged occlusion in a warm, humid environment. Although rare, the hands may be affected.
Codes
ICD10CM:
L08.89 – Other specified local infections of the skin and subcutaneous tissue
SNOMEDCT:
51212009 – Pitted keratolysis
L08.89 – Other specified local infections of the skin and subcutaneous tissue
SNOMEDCT:
51212009 – Pitted keratolysis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Tinea pedis
- Juvenile plantar dermatosis – Scaling, erythema, and fissuring of the feet bilaterally caused by repeated cycles of excessive moisture followed by rapid drying.
- Tinea nigra
- Keratolysis exfoliativa – Noninflammatory, asymptomatic condition affecting the soles that presents with scaling in annular or circinate patterns.
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Therapy
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References
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Last Reviewed:10/28/2019
Last Updated:11/05/2019
Last Updated:11/05/2019

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