Plantar hyperhidrosis and pitted keratolysis treated with botulinum toxin injection.

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.