Holes on the soles

WHEN a patient presents concerned about holes on the soles of the feet, the diagnosis is a condition called pitted keratolysis.

This honeycombed erosion of the thick stratum corneum is due to the bacterium Kytococcus sedentarius, which produces serine proteases that can degrade keratin. It is the thick, weight-bearing areas of the soles that are primarily involved and sufferers invariably have very sweaty feet or wear occlusive footwear.

Topical erythromycin gel or 1% clindamycin lotion applied twice daily will remove the bacteria and allow the keratin to reform normally. Applying some Prantal powder to reduce sweating and wearing leather shoes may also help. For further images and treatments of this condition, visit www.skinconsult.com.au.