655-662 Pitted Keratolysis
Fig. 1 Histology of Case 1 (H & E) Pit is confined to stratum corneum. Fig. 2 High Power Magnification of Fig. 1 Microorganisms are seen at superficial layer. Fig. 3 PAS-positive organisms are seen at superficial layer. Fig. 4 Most coccoid bodies are near surface and filaments are invading stratum corneum (PAS).
Fig. 5 Clinical Feature of Case 5 A: Numerous superficial erosions of the bony layer of the under surface of the toes are faintly visible. B: Soaking the foot in water for 10 min accentuate the lesions.
Fig. 6 Clinical Feature of Case 6 A: Before soaking the foot in water. B: After soaking the foot in water.
Table 1 Summary of Patients
Table 2 Summary of Reported Cases in Japan
26. Nordstrom KM, McGinley KJ, Cappiello L: Pitted keratolysis, Arch Dermatol,123: 1320-1325, 1987 27. Taplin D, Zaias N: The etiology of pitted keratolysis, Report Sz/298. 13th International Congress of Dermatology, Munich, 1967. Bergmann JF-Zaias N: Pitted and ringed keratolysis, Am Acad Dermatol, 7:787-791, 1982 æ èˆø p 1991 30. Holland KT, Marshall J, Taylor D: The effect of dilution rate and ph on biomass and proteinase production by Mierococcus sedentarius grown in continuous culture, J Applied Bacteriol, 72: 429-434,1992 31. Gill KA Jr, Buckels LJ: Pitted keratolysis, Arch Dermatol, 98: 7-11, 1968 28. Guillum RL, Qadri H, Al-Ahadal MN et al: Pitted keratolysis; A manifestation of human dermatophilosis, Dermatolgica, 177: 305-308, 1988 29. Hanel H, Kalish J, Keil M et al: Quantification of keratinolytic activity from Dermatophilus congolensis, Med Microbiol Immunol, 180:45-51, 33. Bergey' s Manual for Determinative Bacteriology, 9th Ed, Williams & Wilkins, Baltimore, 1994, 88 34. Zaias N: Pitted and ringed keratolysis, Am Acad Dermatol, 7: 787-791, 1982 Pitted Keratolysis Nobuhiko Higashi, Shigetoshi Sano and Akihiro Kume Department of Dermatology, Sakai Municipal Hospital 2-1-1, Nishi, Shukuin-cho, Sakai, Osaka 590, Japan Key words: pitted keratolysis-corynebacterium sp.-micrococcus sp. Six cases of pitted keratolysis were reported and reviewed the reported cases of pitted keratolysis in Japan. Our three patients were female. All six patients complained of malodor and hyperhidrosis. They developed pitted erosions of the stratum corneum on the soles of the feet. Five patients had sore foot in walkig. Corynebacterium sp. and micrococcus sp. were isolated from the lesions of three patients. All six patients were treated with josamycin. Within a few weeks, the symptoms and the eruption were subsiding. The biopsy specimens showed that the pits were confined completely to the stratum corneum. The organism was at the base and sides of the pit. Coccoid bodies are frequently seen near the surface of stratum corneum and filamentous organisms are seen infiltrating the stratum corneum. Several organisms have been implicated as the etiological agent of pitted keratolysis. On the basis of microscopic findings and the cultural findings, both of micrococcus sp. and corynebacterium sp. may be etiological agents in most cases of pitted keratolysis. The other organisms also may be etiological agent in a few cases.