Plantar hyperhidrosis and pitted keratolysis treated with botulinum toxin injection

Abstract

Background: Sulcate plantare keratolysis or pitted keratolysis (plantar keratolysis sulcatum) is a disease that is commonly found in tropical countries. Patients have also reported plantar hyperhidrosis.

Objective: Two patients with pitted keratolysis resistant to topical and systemic treatments are described.

Methods: Both patients were injected with botulinum toxin distributed evenly through the plantar extension.

Results: The response to the treatment was excellent despite using a low dose of botulinum toxin with the plantar keratolysis healing completely.

Conclusion: Hyperhidrosis may be considered the major etiologic factor for pitted keratolysis that does not respond to treatment.