Pitted keratolysis is a superficial infection of the plantar feet caused by Kytococcus sedentarius, previously called Micrococcus.

K. sedentarius produces proteases that degrade keratin.

Risk factors for infection include hyperhidrosis, prolonged occlusion, and increased skin pH.

Redness and shallow, round and irregular pits or craters; pits coalesce to have serpiginous borders and occur on the weight-bearing parts of the soles (Fig. 5.10).

Malodor and hyperhidrosis are common.

Usually asymptomatic but can be associated with painful lesions, especially in children.

Based on clinical findings.

Perform Gram stain of stratum corneum shavings to find gram-positive cocci, if necessary.