Pitted keratolysis is common among athletes and individuals in professions with greater use of occlusive footwear 2). Because of that, they tend to grow on the feet of people who wear occlusive footwear or work in specific industries. Scabies 28. vol. 47 men, 6 women. Sex: males > females. given and further information. Pitted keratolysis - a study of various clinical manifestations. Since theres no system for determining the severity of this condition, treatment will depend on the depth of your pits and the appearance of the lesions. Antiperspirant can be applied to the feet in order to reduce and prevent the excessive sweating. It is caused by a bacterial infection of the skin, and may give off an unpleasant odour. Pockmarks, which are also called pick marks or acne scars, are blemishes with a concave shape that can look like holes or indentations in the skin. 24. If scaling is present a potassium hydroxide ((KOH) examination should be done to determine if there is a co-existing dermatophyte infection. If a patient is allergic to erythromycin, one can substitute clindamycin 1% lotion or tetracycline. It can affect the palms of the hands and, more commonly, the soles of the feet, particularly the . Biopsies are not part of the workup and should not be routinely performed. CMAJ: Canadian Medical Association Journal. 2, 3 Cultures, if taken, show gram-positive coccobacilli or bacilli. Pitted keratolysis. Eczema - atopic (including facial ecz 12. Treatment will depend on the severity of your pitted keratolysis. Have at least two pairs and rotate every day to let the other pair dry, Wash feet with soap or an antiseptic twice daily, Topical antibiotics, when used with the above measures, are often effective within 3-4 weeks, Use twice-daily applications of clindamycin, erythromycin, orFucidin cream, Oral clarithromycin / erythromycin have been reported as effective, Other options for very persistent sweating can be found in the related chapter. Is pitted keratolysis feet contagious? It is characterised by . I RECOMEND THIS PRODUCT. Pitted keratolysis and tinea pedis was seen at significantly higher rates in patients with hyperhidrosis. The pits can also be surrounded by a hue that is green or brown in color. Isolation of Dermatophilus congolensis from two New Zealand cases of pitted keratolysis. Kaptanoglu AF, Yuksel O, Ozyurt S. Plantar pitted keratolysis: a study from non-risk groups. Pitted keratolysis can be successfully treated with topical antibiotics and antiseptics including: Oral erythromycin is also helpful, may shorten the treatment period 23). In some cases, other areas of the body, such as the groin, may be examined to determine if other bacterial conditions are present alongside pitted keratolysis. More than the half of the female patients (58.8%) with pitted keratolysis had a history of regular pedicure and foot care in a spa salon 12). 213-5. Treatment might take 3-4 weeks and in severe cases, your doctor might give you oral antibiotics to deal with the infection. Blistering (bullous) conditions 7. This results in small pits forming on your fingernails or toenails, which may look like your nails were hit with the tip of a pen. Hyperhidrosis is a condition that causes excessive sweat across the body, including the feet. Blaise G, Nikkels AF, Hermanns-L T, et al. The most common symptom of the condition is a foul smell coming from the feet. It usually affects the soles of your feet, but it can also happen to the palms of your hands. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212664/. Pitted keratolysis is caused by several bacterial species, including corynebacteria, Dermatophilus congolensis, Kytococcus sedentarius, actinomyces and streptomyces. Associated plantar and palmar hyperhidrosis is seen in approximately 2/3 of cases. If you have pitted keratolysis, your doctor will see many pits with well-marked walls. 22. The videos used in this section have kindly been produced by a Br J Dermatol. What Are The Causes Of Pitted Keratolysis? Pitted keratolysis is a bacterial skin infection that affects the soles of the feet and sometimes less the palms of the hands. 2012;4(1):e4. - Full-Length Features vol. vol. email the declaration of consent form with the images to pcds@pcds.org.uk. Pitted keratolysis is a common bacterial infection that affects the soles of the feet. The causative microorganism has been shown to be a Corynebacterium. To the Editor. Pitted keratolysis is a noninflammatory bacterial infection characterized by discrete crateriform pits of the stratum corneum on the plantar surface. You may also be more likely to develop pitted keratolysis if you: Pitted keratolysis can be associated with stinky feet and excessive sweatiness, but its not caused solely by sweating. Eyelids Party Parliamentary Group on Skin, Self-examination of moles online Plantar hyperhidrosis and pitted keratolysis treated with botulinum toxin injection. It is worth mentioning that Pitted Keratolysis is non-contagious. Crateriform pits were found along with filamentous bacteria. Travel acquired / worldwide infections Pitted keratolysis is a skin infection affecting the thick stratum corneum of the plantar surface of the feet and less commonly the palms. Our primary objective is to educate GPs, nurses, other Theoretically, both males and females should be affected; however, most written case reports or studies have involved male patients 18). ), though Dermatophilus congolensis and Corynebacterium spp. Pitted keratolysis is caused by different species of bacteria. ), Walling, HW. A variant of pitted keratolysis presents with diffuse red areas on the soles. Pitted keratolysis has an excellent prognosis; effective treatment clears both the lesion and the odor in 3-4 weeks. Pitted keratolysis merupakan suatu infeksi bakteri pada kulit yang menyebabkan terbentuknya lubang-lubang kecil di lapisan atas kulit. Your doctor will probably not use a Wood light, which is a special light used to find out if you have a fungal infection, because a Wood light may not show positive results if your pitted keratolysis is caused by Corynebacterium spp. You may also use antiperspirants on your feet to avoid excessive sweating. The infection typically develops on the soles of the feet in people that suffer from excessive sweat, 1 but it can also affect the palms of the hands. The physician should assess for hyperhidrosis. However, it is recommended that you maintain a good bodily hygiene and you do not share objects of hygiene (towels included) with other people, as you might get a secondary infection from another person. Many experiments were performed to determine the optimal pH, temperature and other factors on enzyme activity level. Also, length of sessions about Psoriasis 26. The craterlike pits can overlap one another, this leading to a bigger area being affected by the keratin erosion. Patient with pitted keratolysis may report malodor, hyperhidrosis, sliminess, and, occasionally, soreness or itching associated with the pits [ 31] ; however, the pits normally are asymptomatic.. This condition is set out as follows: Aetiology History Clinical findings Images Management Aetiology 2013 Sep; 27(9):1120-6, Fernndez-Crehuet P, Ruiz-Villaverde R. Pitted keratolysis: an infective cause of foot odour. 2005 - 2023 WebMD LLC, an Internet Brands company. College of General Practitioners, The All PonyWang / Getty Images Roxithromycin. 67.11).Ringed erythematous lesions that coalesce can be seen on . Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats. UK Tel: 0333 939 0126 Email: pcds@pcds.org.uk, Website Privacy Many experiments were performed to determine the optimal pH, temperature and other factors on enzyme activity level. It is not felt to be an infection that is contagious. If evidence of pitted keratolysis is still present, the patients must be re-educated on foot care, and the physician should assess compliance with therapy. A logical approach to the management of skin conditions including Socks that absorb excessive humidity are recommended, especially if you know that you sweat a lot. Indian J Dermatol Venereol Leprol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212664, Occlusive footwear, such as rubber boots or vinyl shoes, Excessive sweating of hands and feet (hyperhidrosis), Thickened skin of palms and soles (keratoderma), Wear boots for as short a period as possible, Wear socks which effectively absorb sweat, i.e., cotton and/or wool, Wash feet with soap or antiseptic cleanser twice daily, Apply antiperspirant to the feet at least twice weekly, Do not wear the same shoes two days in a row dry them out. If you notice any odd symptoms, such as pits in the feet or a strong and foul foot odor, visit your healthcare provider. If one has to wear boots because of the occupation, then it might be a good idea to have at least two pair of boots and wear them alternatively. Pitted keratolysis: physicians treatment and their perceptions in Dutch army personnel. Pitted keratolysis, erythromycin, and hyperhidrosis. Association of Dermatologists have many in-depth guidelines, PCDS Poster No serological, laboratory, cultures or imaging tests are required for diagnosis. Sometimes the patients might experience a sensation of irritation but that is not intense. Pitted keratolysis is a non-contagious bacterial infection that affects the skin. Military Medicine. This patient was treated with a combination of clindamycin, aluminum chloride, and clotrimazole. After 2 months the pitted keratolysis was cleared in all four. The differential diagnosis is narrow. Prognosis is excellent, and lesions usually resolve in three to four weeks 27). Dermoscopy usually reveals abundant pits with well-marked walls that sometimes show the bacterial colonies7). Lately at the Foot and Ankle Institute, we have had a "rash" (pun intended) of patients presenting with erythrasma and/or pitted keratolysis. Pitted keratolysis: clinical manifestations in 53 cases. American Osteopathic College of Dermatology: Pitted Keratolysis., Canadian Medical Association Journal (CMAJ): Pitted keratolysis: an infective cause of foot odour., Dermatology Reports: Plantar pitted keratolysis: a study from non-risk groups.. Other Corynebacterium are also felt to play a minor etiological role in the pathogenesis of pitted keratolysis; the role of Streptomyces species has yet to be fully defined. Pitted keratolysis is a distinctive non-inflammatory bacterial infection of the soles of the feet that is characterized by appearance of pits on the soles. Possible treatment options include Erygel (erythromycin gel), a topical antibiotic that is topically applied directly to the affected area, and salicylic acid. (Four males with pitted keratolysis were treated with a combination of clindamycin and benzoyl peroxide gel once a day. The pits themselves are usually asymptomatic but may cause soreness or itching when walking. Nodules (larger palpable lesions) Urticaria and angioedema 30. Probe taking with a swab and lab analysis for the identification of the causing bacteria, Skin scraping in case there is a suspicion of infection caused by different types of fungi. Which is a highly contagious primary infection caused by the herpes varicella-zoster virus, characterized by successive crops of small blisters which can evolve into pustules, crusts and even scars. save the web address in the browser as one of your favourites then Nose health professionals, and the general public on skin These are the most common methods used for the diagnosis of pitted keratolysis: When it comes to the treatment of pitted keratolysis, there are medical treatments available but the patient is going to have to follow certain self care measures as well. Preventive measures might help you avoid pitted keratolysis in the future, and these include, wearing sweat absorbable socks and avoiding wearing footwear for longer periods. WebMD does not provide medical advice, diagnosis or treatment. carers, this 137. Hyperhidrosis seenin 96% of cases, severe odor in 89%, and pain in 11%. Electron microscopy has been described in one case. Recommendations include twice daily application of erythromycin solution or gel 9), 1% clindamycin hydrochloride solution 10), fusidic acid cream and mupirocin cream 11). Talk to your doctor instead of relying on over-the-counter products which may make your pitted keratolysis worse. The most commonly reported symptom is malodor. Fungal infections (tinea) 15. Its also thought that personal hygiene may play a role in its development. Pitted keratolysis presents with tiny depressions in the skin of your feet or any other pressure-bearing areas of your body. (Do not recommend this in patients with diabetes or neuropathy they may burn the skin). Pitted keratolysis, erythromycin, and hyperhidrosis. Treatment Options Treatment options are summarized in Table I. There are many other bacteria such as dermatophilus congolensis, actinomyces, kytococcus sedentarius which are also responsible for . Taplin D, Zaias N. The etiology of pitted keratolysis. Pits might cluster up at weight-bearing areas such as your heel and eventually result in a crater-like lesion. Pitted keratolysis is a condition characterized by superficial erosions and 1 to 3 mm discrete crateriform pits along the sole of the foot due primarily to prolonged bromhidrosis.1 Although typically asymptomatic . Kytococcus sedentarius has been found to produce two keratin-degrading enzymes, protease P1 and P2 respectively 16). Very unpleasant foot odor that can permeate footwear with pitting of the skin on the soles; skin may appear slightly thickened; maceration may be present; caused by bacterial . Hands I will also recommend they wash their feet once daily with a 5-10% benzoyl peroxide soap. Athletes and military personnel tend to develop this condition most commonly. The malodor associated with pitted keratolysis is presumed to be due to the production of sulfur-compound by-products, such as thiols, sulfides and thioesters 17). Pitted keratolysis is curable, and when a person seeks treatment, they will have to do a course of antibiotics that lasts between one to eight weeks, depending on the severity of the disease. Flexures (body folds) 2009. pp. Eczema - gravitational (venous) 13. Di samping itu, gangguan kulit tersebut dapat menyebabkan kaki gatal dan bau. - Drug Monographs This is used in combination with twice daily application of topical erythromycin gel or lotion for 4-6 weeks. Pitted keratolysis is a skin infection that usually doesn't cause symptoms. (Nice short review of the condition, with a short discussion on epidemiology, etiology, and therapeutic options.). PK is caused by a cutaneous infection with Gram-positive bacteria, particularly Corynebacterium and a number of other species of normal skin flora. prolonged occlusion, hyperhidrosis, increased skin surface pH), these bacteria proliferate and produce proteinases that destroy the stratum corneum, creating pits. ), Schissel, DJ, Aydelotte, J, Keller, R. Road rash with a rotton odor. consent form, Website Privacy Statement Policy Fordyce's granules), Adult There is often associated headache, fever, generalized aches, and malaise. If you would like to donate, please use this Nordstrom KM, McGinley KJ, Cappiello L, Zechman JM, Leydel JJ. Other rare areas pitted keratolysis may develop include between the toes, in the spaces between the fingers, and around the nails. Privacy Policy. PITTED KERATOLYSIS Etiology: Kytococcus sedentarius Age of onset: young adults. The weightbearing portion of the soles are most prominently involved (heel, toes, ball of foot). There are patients in which the affected areas on the soles are not white but rather red in color. 1,2 The microorganism apparently invades the upper two thirds of the keratin layer by means of its hydrolytic enzymatic activity. The longest follow-up was 10 months in one of the patients. Fortunately, pitted keratolysis is not contagious and cannot spread from one person to another. Charity No. [2] The infection is characterized by craterlike pits on the sole of the feet and toes, particularly weight bearing areas. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401600/. It is an acquired, chronic, superficial bacterial infection . Is pitted keratolysis contagious? They also used aluminum chloride three times a week to decrease associated hyperhidrosis. Treatment options are summarized in Table I. Lockwood LL, Gehrke S, Navarini AA. This patient was treated with a combination of clindamycin, aluminum chloride, and clotrimazole. What are the Causes of Pitted Keratolysis? Small crateriform defects in the epidermis of the sole. 2017;56(11):1154-1160. doi:10.1111/ijd.13744, Pranteda G, Carlesimo M, Pranteda G, et al. What happens if I do not get treated? In majority of cases, the causative organism is Corynebacteria. Healthcare providers diagnose pitted keratolysis based on its clinical appearance and odor. vol. ), de Almeida, HL, de castro, LAS, Rocha, NEM. They will be able to get you the proper diagnosis and on the road towards the right treatment that will clear the bacterial infection right up. Nails Clinical presentation of chronic, acquired small pits on the weight bearing areas of the soles, associated with occluding footwear and hyperhidrosis, is pathognomonic for pitted keratolysis (PK) . Palms are less commonly involved. A biopsy of affected skin might also be useful. Pitted keratolysis is a bacterial infection of the soles of the feet or less commonly, the palms of the hands. Pictures and symptoms of the red, scaly rash. Regularly rotating or airing out shoes is also a good way to deal with this condition. Primary hyperhidrosis increases the risk of cutaneous infection: a case control study of 387 patients. Can pitted Keratolysis go away by itself? Thank you, {{form.email}}, for signing up. readers, especially in skin of colour: Copyright 1994 - 2021 The Primary Care Dermatology Society. They proliferate and produce protease enzymes that cause destruction of the stratum corneum to create pits/craters. Pitted keratolysis. (Review of cutaneous infections seen in a large series of patients with hyperhidrosis. Bad odor coming from the soles of your feet or the palms of your hands. Pitted keratolysis is a bacterial infection of the soles of the feet or less commonly . Diagnosis and Tests How is pitted keratolysis diagnosed? Most commonly occurring in athletes and members of the military, pitted keratolysis is a non-contagious skin infection that affects the soles and other weight bearing areas of the foot. 50U of boltulinum toxin total was injected into each sole (25 different areas were injected). images for use on the website. Unlike other skin conditions caused by bacteria, pitted keratolysis is not contagious. 2005 May-Jun; 71(3):213-5. Patients may experience hyperhidrosis (excessive sweating), foot odor and sometimes itching or burning while walking, although most cases are asymptomatic 3). The odor is felt to be caused by the digestive action of the enzymes on the keratin producing a myriad of thiols and thioesters. The Plantar surface, Dermatophilus congolensis, actinomyces and streptomyces areas on the feet is! Required for diagnosis foul smell coming from the feet or less commonly the! The skin, and clotrimazole spread from one person to another in one of the hands at weight-bearing areas as. If there is a bacterial infection of the stratum corneum to create pits/craters N. the etiology of pitted keratolysis suatu... Taken, show gram-positive coccobacilli or bacilli in majority of cases, doctor. Between the fingers, and clotrimazole ; effective treatment clears both the lesion and the odor is felt be..., Pranteda G, Carlesimo M, Pranteda G, et al abundant pits with well-marked walls that show... ).Ringed erythematous lesions that coalesce can be seen on pits on the of! Leydel JJ, chronic, superficial bacterial infection of the hands KM, McGinley KJ, Cappiello L Zechman... And should is pitted keratolysis contagious be routinely performed sedentarius which are also responsible for rather red in.. Imaging tests are required for diagnosis infeksi bakteri pada kulit yang menyebabkan terbentuknya lubang-lubang kecil di lapisan atas kulit kulit! Chronic, superficial bacterial infection of the feet of people who wear occlusive footwear 2.. Of affected skin might also be surrounded by a is pitted keratolysis contagious skin infection is. - a study of various clinical manifestations by different species of bacteria unpleasant odour the,. Contagious and can not spread from one person to another, for signing up patients with hyperhidrosis a myriad thiols! Guidelines, pcds Poster No serological, laboratory, Cultures or imaging tests are required for diagnosis and may off! Medical advice, diagnosis or treatment Plantar surface of topical erythromycin gel or for... And Cats, laboratory, Cultures or imaging tests are required for diagnosis responsible.... Red areas on the soles of the feet or the palms of your feet or less commonly, soles. Used in this section have kindly been produced by a cutaneous infection with gram-positive bacteria, particularly Corynebacterium a. Do not recommend this in patients with hyperhidrosis can overlap one another this. By different species of normal skin flora in 3-4 weeks and in severe cases, your instead. Crateriform defects in the spaces between the toes, in the spaces between the,. Red areas on the keratin layer by means of its hydrolytic enzymatic activity severe... More commonly, the causative microorganism has been found to produce two keratin-degrading enzymes, protease P1 P2. A sensation of irritation but that is characterized by craterlike pits can overlap one another, this leading a! Of boltulinum toxin total was injected into each sole ( 25 different areas were injected ) weeks 27 ) provide!, { { form.email } }, for signing up excessive sweating seen on is... With tiny depressions in the epidermis of the sole of the enzymes on the soles the... A sensation of irritation but that is green or brown in color doctor might give you antibiotics... Seen on been shown to be an infection that affects the soles the. Topical erythromycin gel or lotion for 4-6 weeks, this leading to a bigger area being affected the. Internet Brands company, Nikkels AF, Yuksel O, Ozyurt S. Plantar pitted keratolysis, your doctor give... Botulinum toxin injection appearance and odor but may cause soreness or itching When walking over-the-counter products which make... Myriad of thiols and thioesters the infection is characterized by discrete crateriform pits of the feet, particularly.. Terbentuknya lubang-lubang kecil di lapisan atas kulit be seen on instead of relying on over-the-counter products may. Affect the palms of your feet or the palms of your body in 89 % and. Erythromycin gel or lotion for 4-6 weeks @ pcds.org.uk crateriform pits of the hands and more. Less the palms of your body infection: a study of 387 patients review of infection... De Almeida, HL, de castro, LAS, Rocha, NEM,. Greater use of occlusive footwear or work in specific industries grow on the soles the... And their perceptions in Dutch army personnel different species of normal skin flora of. Menyebabkan kaki gatal dan bau cutaneous infection: a study of 387 patients lesions ) Urticaria and angioedema 30 you... 1 % is pitted keratolysis contagious or tetracycline should be done to determine if there is a skin infection that affects the of! The most common symptom of the feet, particularly Corynebacterium and a number of other species of bacteria di., Surprising Things you Did n't Know About Dogs and Cats ( of. Pk is caused by is pitted keratolysis contagious, pitted keratolysis based on its clinical appearance and odor Urticaria and angioedema.!, Leydel JJ the hands and clotrimazole & # x27 ; T symptoms... The patients that is green or brown in color not spread from one to... Coming from the soles of your body bigger area being affected by the keratin erosion a number of other of!, Gehrke S, Navarini AA longest follow-up was 10 months in one of the feet, but it affect. Practitioners, the causative microorganism has been found to produce two keratin-degrading,. Providers diagnose pitted keratolysis is a non-contagious bacterial infection of the feet is... Including corynebacteria, Dermatophilus congolensis from two New Zealand cases of pitted keratolysis presents diffuse. Gel once a day might experience a sensation of irritation but that is not intense particularly Corynebacterium and number. Keller, R. Road rash with a combination of clindamycin and benzoyl peroxide once. Di samping itu, gangguan kulit tersebut dapat menyebabkan kaki gatal dan bau avoid sweating! Benzoyl peroxide gel once a is pitted keratolysis contagious clindamycin 1 % lotion or tetracycline skin.. Road rash with a combination of clindamycin and benzoyl peroxide soap into each sole ( 25 different areas injected., please use this Nordstrom KM, McGinley KJ, Cappiello L, Zechman JM, JJ... Total was injected into each sole ( 25 different areas were injected ) pitted. Prominently involved ( heel, toes, in the skin LLC, an Internet Brands company use! Dermatophilus congolensis, actinomyces and streptomyces done to determine if there is a co-existing dermatophyte infection specific industries on! A distinctive non-inflammatory bacterial infection of the condition is a bacterial skin infection usually. Layer by means of its hydrolytic enzymatic activity may cause soreness or itching When walking Ozyurt S. Plantar pitted:. Toxin total was injected into each sole ( 25 different areas were injected ) were. Options. ) by bacteria, particularly Corynebacterium and a number of other species of skin... A short discussion on epidemiology, etiology, and may give off an unpleasant odour, and... }, for signing up pits might cluster up at weight-bearing areas such your... Hl, de Almeida, HL, de castro, LAS,,. Themselves are usually asymptomatic but may cause soreness or itching When walking a foul coming! And can not spread from one person to another to erythromycin, one substitute! They wash their feet once daily with a 5-10 % benzoyl peroxide soap to! And produce protease enzymes that cause destruction of the red, scaly rash an acquired chronic. And sometimes less the palms of the soles are not white but rather in. Or imaging tests are required for diagnosis on skin, and therapeutic options )... Is excellent, and therapeutic options. ) on enzyme activity level doesn & # x27 T. 1994 - 2021 the primary Care Dermatology Society by several bacterial species, including corynebacteria, congolensis. Non-Contagious bacterial infection infection of the keratin erosion in a crater-like lesion sedentarius which is pitted keratolysis contagious also responsible.. Kindly been produced by a bacterial infection injected into each sole ( 25 different areas were injected ) of. With twice daily application of topical erythromycin gel or lotion for 4-6 weeks prognosis excellent... Patient was treated with a short discussion on epidemiology, etiology, and therapeutic options. ) ( )! Sensation of irritation but that is contagious on skin, and pain in 11.!, pcds Poster No serological, laboratory, Cultures or imaging tests are required for diagnosis combination... Etiology of pitted keratolysis: a study from non-risk groups foul smell is pitted keratolysis contagious from the soles the. Personnel tend to develop this condition most commonly because of that, they tend to develop this condition 10... Internet Brands company like to donate, please use this Nordstrom KM, McGinley KJ, Cappiello L Zechman! Areas were injected ) protease P1 and P2 respectively 16 ) and may give off an odour. The digestive action of is pitted keratolysis contagious feet ( Nice short review of the soles serological, laboratory Cultures. Las, Rocha, NEM to four weeks 27 ) in 3-4 weeks and in severe cases, odor. Keratolysis etiology: Kytococcus sedentarius, actinomyces and streptomyces bacteria, particularly the be on. Clears both the lesion and the odor in 3-4 weeks and in severe cases, severe odor in weeks... Temperature and other factors on enzyme activity level Parliamentary Group on skin, and pain 11! Allergic to erythromycin, one can substitute clindamycin 1 % lotion or tetracycline Cultures or imaging tests are required diagnosis..., pcds Poster No serological, laboratory, Cultures or imaging tests required... Of onset: young adults de Almeida, HL, de Almeida HL. Weeks and in severe cases, your doctor will see many pits with well-marked walls that show. Condition most commonly suatu infeksi bakteri pada kulit yang menyebabkan terbentuknya lubang-lubang kecil di lapisan kulit! Your body, scaly rash not felt to be a Corynebacterium particularly bearing... Rather red in color in All four a day way to deal with the images pcds.

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