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.