Symptomatic Pitted Keratolysis

Pitted keratolysis can be symptomatic when severe and can cause soreness and disability in military personnel. The symptomatic form occurs as plaques of reddened thinning and distinct tenderness at sites of pressure on the soles. Patients all had surrounding areas of the usual asymptomatic pits. All had been in the field in combat for at least two weeks when they first noted discomfort. Sweating was diminished in these plaques and profuse on the rest of the feet. The usual organisms seen with pitted keratolysis were found within the thinned plaques. Various topically applied medications were tried using one foot for treatment and the other foot for control. A 40% Formalin ointment seemed to be the most effective material.