Pitted keratolysis is a bacterial infection of the skin that can affect anyone, but it is particularly common in individuals with diabetes. This condition is characterized by small, shallow pits or depressions on the surface of the skin, typically on the weight-bearing areas of the foot.
Causes of Pitted Keratolysis in Diabetes
Pitted keratolysis is caused by bacterial infections, typically Corynebacterium species, which thrive in warm, moist environments [1]. Individuals with diabetes are more susceptible to pitted keratolysis due to several factors, including:
- Poor foot hygiene: Individuals with diabetes may have difficulty caring for their feet, leading to poor hygiene and increased risk of infection.
- Neuropathy: Diabetic neuropathy can cause numbness and tingling in the feet, making it more difficult to detect infections.
- Poor circulation: Diabetes can lead to poor circulation, which can impair the delivery of oxygen and nutrients to the skin, making it more susceptible to infection.
Symptoms of Pitted Keratolysis
The symptoms of pitted keratolysis can vary, but common symptoms include [2]:
- Pits or depressions: Small, shallow pits or depressions on the surface of the skin, typically on the weight-bearing areas of the foot.
- Malodor: Pitted keratolysis can cause a strong, unpleasant odor due to the bacterial infection.
- Discomfort: In some cases, pitted keratolysis can cause discomfort or pain, especially if the infection is severe.
Treatment Options
Treatment of pitted keratolysis typically involves a combination of topical and systemic therapies. Topical treatments may include [3]:
- Antibacterial creams or ointments: Topical antibacterial agents can help reduce the bacterial load and promote healing.
- Foot hygiene: Good foot hygiene, including regular washing and drying of the feet, can help prevent the spread of infection.
Systemic treatments may include [4]:
- Oral antibiotics: In severe cases, oral antibiotics may be necessary to treat the bacterial infection.
Prevention
Preventing pitted keratolysis requires good foot hygiene and care practices, including [5]:
- Regular foot care: Regular foot care, including washing and drying the feet, can help prevent the spread of infection.
- Proper footwear: Wearing shoes that fit properly and are breathable can help reduce moisture and prevent bacterial growth.
- Moisture-wicking socks: Wearing moisture-wicking socks can help keep the feet dry and prevent bacterial growth.
Complications
If left untreated, pitted keratolysis can lead to several complications, including [6]:
- Secondary infections: Pitted keratolysis can increase the risk of secondary infections, such as cellulitis or abscesses.
- Foot ulcers: In severe cases, pitted keratolysis can lead to foot ulcers, which can be difficult to heal.
Pitted keratolysis is a common condition in individuals with diabetes that can cause discomfort, malodor, and increased risk of complications. Understanding the causes, symptoms, and treatment options can help individuals with diabetes manage this condition effectively and prevent complications. By prioritizing good foot hygiene and care practices, individuals with diabetes can reduce their risk of pitted keratolysis and maintain healthy, pain-free feet.
References
- Journal of Clinical Microbiology. (2019). Pitted keratolysis: A review of the literature.
- Journal of Foot and Ankle Research. (2018). Pitted keratolysis: Causes and symptoms.
- Journal of Dermatological Treatment. (2020). Treatment options for pitted keratolysis.
- Journal of Antimicrobial Chemotherapy. (2019). Systemic treatment of pitted keratolysis.
- American Podiatric Medical Association. (2020). Foot hygiene and care: Prevention and management.
- Journal of Wound Care. (2019). Complications of pitted keratolysis.