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Pitted keratolysis is a skin infection that can be caused by wearing tight or restricting footwear and excessive sweating during exercise. The infection is characterized by craterlike pits on the surface of the feet and toes, particularly weight bearing areas.Pathophysiology: Under appropriate conditions (ie, prolonged occlusion, hyperhidrosis, increased skin surface pH), bacteria proliferate and produce proteinases that destroy the stratum corneum, creating pits. Common organisms causing Pitted Keratolysis are Cutaneous infection with Micrococcus sedentarius, dermatophilus congolensis, actinomyces, K.sedentarius, Staphylococcus epidermidis

Clinical Features: Small punched-out circular lesions are seen on the foot skin. It is associated with peeling, cracking, and scaling of the feet. Redness, blisters, or softening and breaking down (maceration) of the skin may also be present. Itching, burning, or both may occur.

Treatment: This can be successfully treated with topical antibiotics such as fusidic acid cream, or with oral erythromycin. Shoes should be worn for as short a period as possible. Feet should be washed with soap or antiseptic cleanser twice daily. Antiperspirant should be applied to the feet at least twice weekly. Footwear or towels should not be shared with others. Absorbent cotton socks must be changed frequently to prevent excessive foot moisture.For further treatment, patient should consult a podiatrist