What disease causes holes in the body? Understanding Necrosis and Tissue Damage

September 22, 2025 •

5 min read

While the term 'holes in the body' is alarming, it refers medically to several conditions involving tissue damage or necrosis. These can range from superficial bacterial skin infections to life-threatening emergencies. Understanding the underlying pathology is crucial for timely diagnosis and treatment, and it helps to know what disease causes holes in the body in different contexts.

Quick Summary

Numerous medical conditions can cause tissue damage resulting in holes, pits, or cavities. These include severe bacterial infections like necrotizing fasciitis, common skin conditions like pitted keratolysis, and internal organ diseases such as cavitary tuberculosis. The medical term for tissue death is necrosis, which can result from infection, lack of blood flow, or injury.

Key Points

Necrotizing Fasciitis: This is a severe, rapidly progressing bacterial infection known as 'flesh-eating disease' that causes extensive tissue death and requires immediate medical attention.
Pitted Keratolysis: A common and less serious bacterial infection of the skin on the feet and hands, resulting in small, crater-like pits, especially in moist environments.
Internal Cavities: Diseases like tuberculosis and abscesses can cause cavities or pockets of pus to form inside organs such as the lungs.
Other Conditions: Connective tissue disorders, diabetes, and cancer can also cause tissue damage or perforations in various parts of the body.
Importance of Diagnosis: The seriousness of the condition varies widely, making accurate and early diagnosis by a healthcare professional critical for effective treatment and to prevent life-threatening complications.
Treatment Depends on Cause: Treatment can range from simple hygiene and topical antibiotics for superficial issues to extensive surgery and powerful medication for severe infections.

Causes of Tissue Necrosis

Necrosis is the medical term for premature, unnatural cell death and is a key process behind many conditions that cause tissue damage. It can be triggered by infections, injuries, toxins, or compromised blood supply. Unlike apoptosis, which is a controlled cellular self-destruct mechanism, necrosis is an uncontrolled event that releases cellular contents, causing inflammation and damage to surrounding tissues.

Necrotizing Fasciitis: The Most Severe Form

One of the most extreme and dangerous causes is necrotizing fasciitis, often called 'flesh-eating disease.' This is a rare but severe bacterial infection that spreads rapidly and aggressively, causing extensive tissue death.

Causes: Most commonly caused by Group A Streptococcus (GAS), the same bacteria responsible for strep throat, though other bacteria can also be involved.
Entry Points: Bacteria enter the body through a break in the skin, such as a cut, scrape, burn, or insect bite.
Symptoms: Early symptoms resemble the flu (fever, chills, nausea) but progress rapidly to severe pain that is disproportionate to the wound's appearance. The skin may become warm, swollen, and discolored, followed by the formation of blisters and black spots (necrosis).
Treatment: This is a medical emergency requiring immediate hospitalization, surgical removal of dead tissue (debridement), and powerful antibiotics.

Pitted Keratolysis: Holes in the Skin of the Feet

At the other end of the severity spectrum is pitted keratolysis, a common bacterial skin infection characterized by small, crater-like pits in the top layer of the skin, typically on the soles of the feet or palms.

Causes: Caused by bacteria such as Kytococcus sedentarius and Corynebacterium that thrive in warm, moist conditions.
Risk Factors: More common in people with hyperhidrosis (excessive sweating), or those who wear occlusive footwear or live in tropical climates.
Symptoms: The most prominent symptoms are a foul odor and the characteristic pits, which become more noticeable when the skin is wet. Itching or soreness may also occur, especially on pressure-bearing areas.
Treatment: Involves topical antibiotics or antiseptics and, crucially, managing moisture with foot hygiene and breathable footwear.

Internal Cavities and Organ Damage

Some diseases cause internal cavities, which can also be described as 'holes.'

Cavitary Tuberculosis (TB): A significant cause of lung cavities, especially in endemic areas. The bacteria M. tuberculosis can cause areas of the lung to necrose and liquefy, forming a gas-filled space. This is a severe form of the disease with a higher risk of transmission and poor outcomes.
Abscesses: A localized collection of pus within body tissue, often caused by a bacterial infection. Abscesses can form just under the skin (skin abscesses) or deep inside organs like the brain or liver. They can also occur in the mouth (dental abscesses).
Crohn's Disease: This inflammatory bowel disease can lead to the formation of ulcers and, less commonly, perforations or abscesses in the gastrointestinal tract and surrounding tissues. It can also cause mouth ulcers or lesions.

Acquired Perforating Dermatosis (APD)

APD is a skin disorder affecting individuals with chronic kidney disease and/or diabetes mellitus. It presents as firm, itchy papules with a central keratin-filled crater, or 'hole'. Chronic scratching is believed to contribute to its development by causing trauma to an already compromised microvascular system in the skin.

Comparing Diseases that Cause Tissue Damage


Feature	Necrotizing Fasciitis	Pitted Keratolysis	Cavitary Tuberculosis
Affected Area	Deep soft tissue and fascia, most commonly limbs, but can be anywhere.	Superficial skin, primarily soles of feet and palms of hands.	Lungs, where gas-filled cavities form.
Cause	Rapid, aggressive bacterial infection (e.g., Group A Strep).	Bacterial infection (Corynebacterium species) in warm, moist conditions.	Infection with Mycobacterium tuberculosis.
Severity	High. Medical emergency with high mortality rate.	Low. Generally benign and treatable with good hygiene.	High. Serious and associated with poor outcomes and relapse.
Speed of Onset	Rapid, often within hours or days of entry.	Gradual, often developing due to chronic exposure to moisture.	Develops over time, often in cases of untreated or advanced TB.
Sensation	Excruciating pain, disproportionate to wound's appearance.	Usually asymptomatic, but can be painful or itchy with pressure.	Cough, chest pain, coughing up blood.

The Importance of Early Diagnosis

Given the range of conditions that cause tissue damage, from minor to life-threatening, prompt and accurate diagnosis is critical. For rapidly progressing conditions like necrotizing fasciitis, early medical intervention is the single most important factor for survival. For other conditions, early diagnosis can prevent complications and lead to more effective treatment.

When to Seek Medical Attention

Any suspicious wound or skin change that causes severe or rapidly increasing pain, swelling, or skin discoloration requires immediate medical evaluation. Internal symptoms, such as persistent cough, fever, or abdominal pain, should also be investigated by a healthcare provider.

Treatment and Prevention Strategies

Treatment depends entirely on the underlying condition. It can range from topical or oral antibiotics for skin infections like pitted keratolysis, to aggressive surgery and IV antibiotics for severe cases of necrotizing fasciitis. Prevention is often focused on hygiene and managing risk factors:

Practice Good Wound Care: Properly clean and bandage any cuts, scrapes, or burns to prevent bacteria from entering the body. See a doctor for any deep or serious wounds.
Maintain Foot Hygiene: Keep feet clean and dry, especially if you have hyperhidrosis. Wear moisture-wicking socks and alternate footwear to allow shoes to dry.
Manage Underlying Conditions: People with conditions like diabetes, kidney failure, or inflammatory bowel disease should work closely with their doctors to manage their health and watch for related complications, including skin changes or systemic infections.

For more detailed information on preventing severe bacterial infections, visit the Centers for Disease Control and Prevention's website [https://www.cdc.gov/group-a-strep/about/necrotizing-fasciitis.html].

Conclusion

While the sight of holes or pits on the body can be frightening, these visible symptoms are clues to a variety of underlying medical conditions. The causes range from common and treatable bacterial skin infections to rare, life-threatening diseases requiring urgent care. Recognizing the symptoms and understanding the potential causes is essential for seeking the correct treatment. Whether it's a minor skin issue or a severe internal problem, medical professionals have the tools to diagnose and address the source of the tissue damage and facilitate healing.

Frequently Asked Questions

Yes, some skin infections can cause pits or holes. Pitted keratolysis, for instance, is a bacterial infection of the foot that creates small, crater-like pits on the soles, especially when feet are sweaty.

Yes, 'flesh-eating disease' is the common name for necrotizing fasciitis, a very serious and rare bacterial infection that causes the rapid death of soft tissue beneath the skin.

Cavitary tuberculosis (TB) is a notable cause of lung cavities. The bacterial infection can lead to tissue death and the formation of gas-filled spaces within the lung tissue.

Yes. Conditions like acquired perforating dermatosis, associated with chronic kidney failure and diabetes, can cause skin papules with central craters. Certain types of cancer can also lead to tissue breakdown and cavities.

You should seek immediate medical attention for a wound that develops severe, rapidly spreading pain; swelling; discoloration (especially bluish or black); or produces pus, as these are warning signs of serious infections like necrotizing fasciitis.

An abscess is a localized pocket of pus caused by infection. While not a classic 'hole,' it is a cavity filled with pus that can form under the skin or within organs. If left untreated, a burst abscess can cause the infection to spread.

Prevention depends on the cause but often includes good hygiene, managing underlying medical conditions like diabetes, and properly caring for any skin wounds to prevent bacterial entry. For pitted keratolysis, keeping feet dry is key.