Two concentrations of benzoyl peroxide gel can treat pitted keratolysis

Topical benzoyl peroxide gel 2.5% and 5% can both treat pitted keratolysis according to study results presented at the American Academy of Dermatology virtual meeting.

“Pitted keratolysis (PK), a common skin disease, is frequently accompanied by pitted lesions on the feet and malodor,” Charussri Leeyaphan, MD, of the department of dermatology, faculty of medicine Siriraj Hospital, Mahidol University, Bangkok, and colleagues wrote. “The over-the-counter drug topical benzoyl peroxide gel (BP) is used as a medication for PK. However, the appropriate dosage and duration of BP treatment of PK is controversial.”

In a randomized, controlled trial to assess the safety and effectiveness of topical 2.5% BP and 5% BP, 89 subjects diagnosed with PK were analyzed. Subjects were assigned either 2.5% or 5% BP and were asked to apply the topical medication once daily for 2 weeks. Safety and effectiveness were evaluated 2 weeks after treatment via clinical examinations and self-assessments.

Of 42 subjects treated with 2.5% BP, self-evaluation of foot odor using a visual analog scale showed a significant decrease from 5.4 to 3.7 (P < .001). Of 47 subjects treated with 5% BP, the decrease was from 5.4 to 3.5 (P .001).

Pitted lesions were evaluated by treatment-blinded dermatologists, with a 69% improvement for the 2.5% BP group vs. a 63.8% improvement for the 5% BP group. Side effects were not statistically different between the groups, and moderate to high levels of satisfactions were reported from almost all subjects.

“This study demonstrated that either 2.5% or 5% BP can be used for the treatment of PK and foot malodor,” Leeyaphan and colleagues wrote. “Due to the similarities in their efficacies and side effects, the use of 2.5% BP may be preferable.”