A 12-year-old girl presented with malodorous pits over bothsoles associated with hyperhidrosis for the past three months.On cutaneous examination, multiple yellowish-brown circularcrateriform pits (2-5 mm) with punched out appearance wereseen over the ventral aspect of the great toe, the ball, and heel ofboth feet; the pits coalesced into large, shallow maceratedfurrows with focal erosion (Fig. 1). A characteristic sparing ofthe non-pressure bearing areas was noted. Potassium hydroxidemount of skin scrapings showed no fungal elements. Based onthe characteristic history and cutaneous findings, a diagnosis ofpitted keratolysis was made. She was treated with topicalclindamycin and advised to avoid occlusive footwear; thelesions resolved in 3 weeks.
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