Dermoscopy of pitted keratolysis

A 32-year-old gentleman presented with irritated malodourous hyperhidrotic soles with multiple small pits, diagnosed as pitted keratolysis or keratosis plantare sulcatum [Figure 1]. It is a superficial bacterial infection caused by organisms such as Corynebacterium spp., Actinomyces spp., Dermatophilus congolensis, and Kytococcus sedentarius. Dermoscopy of pitted keratolysis showed multiple clustered and scattered, crateriform pits on weight-bearing areas of the soles, having irregular shape, well-defined margins, and punched-out edges, containing brown-black dirt and debris, along with break in the dermatoglyphics [Figure 2] (DermLite DL3N, dry, contact, polarized, ×10).

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Figure 1:

Soles with multiple small pits at pressure areas of the soles.

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Figure 2:

Dermoscopy of pitted keratolysis showing multiple clustered and scattered, crateriform pits having irregular shape, well-defined margins, and punched-out edges, containing brown-black dirt and debris, along with break in the dermatoglyphics (DermLite DL3N, dry, contact, polarized, ×10).

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