Conflict of interest None
Pitted keratolysis; physicians’ treatment and their perceptions in Dutch army personnel
Article first published online: 7 AUG 2012
© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 27, Issue 9, pages 1120–1126, September 2013
How to Cite
van der Snoek, E.M., Ekkelenkamp, M.B. and Suykerbuyk, J.C.C.W. (2013), Pitted keratolysis; physicians’ treatment and their perceptions in Dutch army personnel. Journal of the European Academy of Dermatology and Venereology, 27: 1120–1126. doi: 10.1111/j.1468-3083.2012.04674.x
Funding Source None
- Issue published online: 28 JUL 2013
- Article first published online: 7 AUG 2012
- Received: 20 March 2012; Accepted: 10 July 2012
Background Pitted keratolysis (PK) is a common plantar skin manifestation in army personnel, farmers and athletes. Due to pain while walking and marching, the condition can cause reduced operational deployability (in case of army personnel).
Objective We used a questionnaire to investigate currently used treatment options of PK and perceptions on perceived efficacy of these treatments among Royal Netherlands Armed Forces primary health care physicians.
Methods A cross-sectional anonymous postal questionnaire survey was conducted among all Royal Netherlands Armed Forces primary health care physicians. In addition to question about prescription behaviour on the treatment of PK by topical and oral therapies and given non-pharmacological treatment, several questions assessed perceived efficacy of these therapies.
Results Of the 164 eligible primary health care physicians, 51 (31.1%) completed the questionnaire. Half of physicians had seen less than five patients with PK in the preceding year. Two-thirds of physicians reported problems with operational deployability in less than 10% of army personnel with PK. PK was treated mostly with topical and non-pharmacological treatments. Oral therapy was seldom prescribed. For hyperhidrosis, aluminium chloride hexahydrate was used in most cases.
Conclusion PK and related reduced operational deployability were less often reported than expected in this study. Dutch physicians prefer combined topical antibiotic therapy with non-pharmacological treatments and perceive the efficacy of topical antibiotic therapy superior to non-pharmacological treatments. Preventive measures, topical antibiotic therapy and adequate treatment of hyperhidrosis are the mainstay methods in the management of patients with PK.