Which physical findings are characteristic of pitted keratolysis?

Updated: Jul 30, 2018
  • Author: Linda J Fromm, MD, MA, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Answer

The primary lesions of pitted keratolysis are pits in the stratum corneum ranging from 0.5-7 mm, with some development of confluence, irregular erosions, or sulci (see the images below).

A large plaque-like lesion of Pitted keratolysis o A large plaque-like lesion of Pitted keratolysis on the large toe.
Pitted keratolysis with hyperkeratosis on the heel Pitted keratolysis with hyperkeratosis on the heel.
Classic pits of pitted keratolysis on the plantar Classic pits of pitted keratolysis on the plantar aspect of the phalanges.
Pitted keratolysis forming sulci on the heel. Pitted keratolysis forming sulci on the heel.

A variant of markedly enlarged lesions, called crateriform pitted keratolysis, also has been described. [33] This affects the entire width of the plantar surface of the foot underlying the metatarsophalangeal joints. The pits are rarely seen on non–pressure-bearing areas of the plantar surface, but this has been reported in the literature. [34]


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