Keratolysis sulcata is a disease of the skin. It occurs on the soles of the feet. It is a bacterial disease.
What is keratolysis sulcata?
Keratolysis sulcata is characterized by a change in the appearance of the skin. On the soles of the feet and, in rare cases, on the palms of the hands, the affected person’s skin becomes diseased due to an infestation of bacteria. There is a change in the cornea in the regions affected by bacteria. Keratolysis sulcata has a punctate to blotchy external appearance. Frequently, sufferers also suffer from increased perspiration as well as an unpleasant odor on the feet. The changes in skin appearance are seen on the soles of the feet, the heel as well as the toes. In addition, it can extend to the spaces between the toes or the folds of the toes. Since the disease can spread strongly to the entire foot in just a few hours, the risk of extensive defects increases. If the itching is indulged in, if the foot is rubbed in shoes that are too big, the bacteria also spread rapidly. At risk are people who sweat frequently on their feet due to work or sports activities, wearing shoes that promote sweating.
Causes
Among the most common causes of keratolysis sulcata is increased sweating accompanied by inadequate antibacterial measures. If footwear is worn for a long period of time, which does not allow good ventilation of the foot, the risk of the disease increases. The same applies if the footwear is worn regularly or worn by different people. If excessive perspiration has developed during wearing and no disinfecting measures have been taken, the risk of contracting keratolysis sulcata increases. In addition, irregular and too infrequent changing of hosiery is a possible cause. Insufficient cleaning of the feet after sweating promotes the growth of the
bacteria as well. All processes that support the growth of the bacteria can trigger keratolysis sulcata as a consequence. Lack of hygiene combined with inadequate care of the feet is the main cause. Since it is a bacterial disease, it is contagious and may have been causally transmitted.
Symptoms, complaints and signs
Symptoms include changes in the appearance of the skin on the feet. Initially, punctate changes form and increase in growth. They often reach a diameter of two to three millimeters and a depth of one to seven millimeters. In most cases, the changes begin in the interdigital spaces of the toes. They continue to spread from the toes until they reach the heel through the sole of the foot. The skin suffers a blotchy dark colored appearance. In severe cases, the skin lesions may also develop on the palms of the hands. Since keratolysis sulcata can spread very widely in just a few hours, immediate action should be taken. Alternatively, there is the threat of an extensive defect of the skin, which attacks the overall health of the foot. Locomotion becomes difficult and is painful from the affected person. In particularly severe cases, walking or standing are no longer possible for the sufferer due to the pain.
Diagnosis and course of the disease
The diagnosis is made by a physician. After visual contact, he or she takes a foot swab. This shows the infestation of bacteria in a laboratory test. The course of the disease can be described as highly progressive. Within a few hours or days, the skin change can spread over the entire foot.
Complications
Keratolysis sulcata primarily causes discomfort to the affected person’s skin. This discomfort is usually spread to the sole of the foot, causing pain when walking and running and usually limiting movement. The quality of life is significantly reduced by keratolysis sulcata. The changes on the skin can also lead to aesthetic discomfort, so that those affected with keratolysis sulcata do not feel comfortable and suffer from reduced self-esteem. Likewise, in most cases, this disease spreads to other regions of the body, so that the same discomfort can appear on the hands and fingers after only a few hours. For this reason, immediate treatment of keratolysis sulcata is usually necessary.The patient’s locomotion is painful, and in severe cases it is no longer possible for the affected person to stand or walk. Treatment is carried out with the help of various creams and ointments. However, the affected person may need to avoid certain materials to prevent the symptoms from recurring. Life expectancy is usually not limited by keratolysis sulcata.
When should you see a doctor?
Changes in the usual skin appearance on the soles of the feet or the palms of the hands, should be examined by a doctor. If abnormalities of the upper layer of the skin occur, a physician should be presented with the observations. If there is a blotchy appearance or discoloration of the skin, there is cause for concern. If the discoloration on the foot or hand spreads further, a doctor’s visit is required. If toes, the spaces between the toes or the entire sole of the foot are affected by the abnormalities, a doctor is needed as soon as possible. The clarification of the cause can only be done by a medical examination. Since keratolysis sulcata is a bacterial disease, skin contact with other people may result in transmission of the disease. If there is an unpleasant odor under the feet or increased sweat production, a medical examination is advised. The affected person should take care to wear healthy footwear and change hosiery immediately. In most cases, the symptoms spread rapidly within a few hours. Therefore, a doctor should be consulted at the first irregularities. A doctor must be consulted in case of itching, discomfort during locomotion or restrictions of mobility. If pain, inner restlessness or a general feeling of indisposition sets in, a visit to the doctor is necessary.
Treatment and therapy
The treatment of keratolysis sulcata is lengthy. It usually lasts for several months. Sufferers are advised to change their hosiery several times a day for freshly washed and disinfected ones. Care must be taken not to use synthetic materials. Feet must be kept dry. If they come into contact with water, they should be dried. After sweating, the feet should be washed and disinfected immediately. Wearing toe socks is recommended. Footwear is checked for quality and usually replaced with breathable footwear. If possible, open-toed footwear should be used while wearing hosiery. The use of special shoe inserts is recommended. These should be replaced regularly as well as disinfected. Disinfection of the feet should be done several times a day. Antibacterial creams should be applied for this purpose. Acidic or greasy creams, ointments or soaps should be avoided. Since the defects of the cornea regenerate only slowly, the measures must be carried out daily for several months. If possible, baths or saunas should be avoided. If increased perspiration occurs during the night, the bed linen should be changed regularly. Hosiery that can absorb the sweat can be worn at night. Care should be taken that the temperature does not increase during sleep. After sports activities, the hosiery should be changed immediately.
Outlook and prognosis
The rapid spread of the disease from the feet to other parts of the body makes for a high degree of suffering, and treatment is usually very lengthy. To improve the quality of life during this time, the affected person can take some measures. Since Keratolysis Sulcata is a bacterial infection, special hygiene must be observed, especially when living with other people. This includes keeping the feet dry at all times and drying them neatly after contact with water. Sweating on the feet must also be taken care of immediately by washing and disinfecting the patient’s feet. Antibacterial creams and freshly washed socks help to keep the germ load low after disinfection. For the night, ensure a regular change of bed linen and a rather low room temperature as well as light bed linen to avoid sweating. In order to reduce the risk of perspiration in advance, synthetic materials should be avoided and open or breathable footwear should be chosen wherever possible. Special shoe inserts or toe socks can also help.If the existing itching gets out of hand, possible medication can be discussed with the doctor, as scratching promotes the spread of bacteria and leads to a significant worsening of the situation.
Prevention
Preventive measures include adequate foot hygiene and breathable footwear. Regular washing of the feet, especially after sweating due to intensive activities is necessary. A daily change of hosiery should be made. Shoes in which sweat is formed should be disinfected or replaced. Wearing of shoes by more than one person should be avoided. The foot should be kept as dry as possible to prevent bacteria from forming. Daily care of the foot with suitable products for regeneration is recommended.
Aftercare
In most cases, very few direct aftercare measures are available to the affected person for keratolysis sulcata. In some cases, there are no options for aftercare at all in this disease. Therefore, in the first place, the affected person should cotanic a doctor very early, so that no further complications or discomfort can occur. The earlier a doctor is consulted, the better is usually the further course of this disease. Self-healing usually cannot occur with keratolysis sulcata. Affected persons should change their clothes very frequently and use only freshly washed clothes. Feet should always be kept dry. If the feet get wet, they must first be dried before socks and shoes are put on. Likewise, footwear should be particularly air-permeable and breathable so that feet do not sweat. Since the feet sweat just as much at night due to keratolysis sulcata, the bedding should also be changed frequently as a rule. Visiting a sauna or the swimming pool should be avoided in this disease. In most cases, keratolysis sulcata does not negatively affect the life expectancy of the affected person.
What you can do yourself
The disease of the cornea on the soles of the feet usually severely limits patients affected by keratolysis sulcata for several weeks to months, often reducing their sense of well-being. Nevertheless, it is essential for the healing of keratolysis sulcata to renew the stockings several times a day. It helps to get into the habit of fixed times and a certain routine in order to integrate the changing of socks, which is perceived as a nuisance, into everyday life. Patients with keratolysis sulcata use hosiery made of natural fibers whenever possible. A high degree of safety is also provided by stockings whose material is suitable for allergy sufferers. In this way, patients prevent further irritation of the cornea. By an adapted and with the physician co-ordinated hygiene of the feet the complaints improve again faster. Patients clean their feet several times a day and use creams with an antibacterial effect specially developed for the treatment of keratolysis sulcata to care for the diseased areas of skin on the soles of their feet. Patients should not be tempted to change products frequently despite the wide range of cosmetic products available, as skin irritation may result. Instead, it is recommended that treatment be carried out consistently with the product prescribed by the physician.
