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.