Abstract
Background Pitted keratolysis (PK) is a superficial bacterial infection diagnosed mainly by clinical manifestations. Current data on its dermoscopic and histopathological findings, and the correlation of those findings, are limited. Objectives To evaluate the clinical manifestations, dermoscopic, and histopathological findings of PK and to determine the correlations. Methods Forty naval cadets with PK and five cadets with normal feet were enrolled this cohort study and provided informed consent. Dermoscopy was independently applied and evaluated by 2 dermatologists. Shave biopsies were performed on 37 patients with PK. Results Pits were the most common dermoscopic finding (88.1%). The dermoscope had more sensitivity for the detection of PK than the naked eye examinations. Apart from the pits and the presence of bacteria, the most common histopathological finding for PK was color alteration of keratin. The presence of bacteria correlated with interrupted dermatoglyphic lines and the color alteration of keratin. Moreover, the presence of bacteria at the base of pits was related to worse treatment outcomes. Conclusions Dermoscopy is a useful tool for PK diagnosis. Color alteration of keratin is another histopathological finding for PK. The presence of bacteria is associated with worse treatment outcomes.
Highlights
Pitted keratolysis (PK) is a superficial bacterial infection caused by many organisms, such as Corynebacterium spp., Actinomyces spp., Dermatophilus spp., and Kytococcus sedentarius [1, 2]
A wide range of pit characteristics can be revealed by dermoscopy, and this study presented detailed dermoscopic findings for PK
This study confirmed that dermoscopy is more sensitive than clinical examinations by the naked eye in terms of the diagnosis of PK
Summary
Pitted keratolysis (PK) is a superficial bacterial infection caused by many organisms, such as Corynebacterium spp., Actinomyces spp., Dermatophilus spp., and Kytococcus sedentarius [1, 2]. Its dermoscopic and histopathological findings have only been investigated by a few studies. The known correlations between the clinical manifestations, dermoscopic findings, and histopathological findings are currently limited. To assess this gap, this study is aimed at evaluating the clinical manifestations, dermoscopic and histopathological findings, and the treatment outcomes of PK patients and identifying the correlations between those factors. To evaluate the clinical manifestations, dermoscopic, and histopathological findings of PK and to determine the correlations. Apart from the pits and the presence of bacteria, the most common histopathological finding for PK was color alteration of keratin. The presence of bacteria at the base of pits was related to worse treatment outcomes. The presence of bacteria is associated with worse treatment outcomes
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