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These conditions are frequently referred to by river runners with a catchall term, \u201ctolio.\u201d Several skin disorders have been identified as components of tolio, with the most prevalent currently being pitted keratolysis. We present a case of pitted keratolysis in a river guide occurring during a multiday river trip, where treatment can be difficult. Prevention is often more important. <\/jats:p>","DOI":"10.1016\/j.wem.2019.09.003","type":"journal-article","created":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T04:44:33Z","timestamp":1580445873000},"page":"82-86","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Tolio: Foot Rot in Grand Canyon River Runners"],"prefix":"10.1177","volume":"31","author":[{"given":"Thomas M.","family":"Myers","sequence":"first","affiliation":[{"name":"Grand Canyon National Park, Branch of Emergency Services, Grand Canyon, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl J.","family":"Bigler","sequence":"additional","affiliation":[{"name":"Northern Arizona Dermatology, Flagstaff, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew B.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Coconino County Public Health Services District, Flagstaff, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene E.","family":"Gaither","sequence":"additional","affiliation":[{"name":"Coconino County Public Health Services District, Flagstaff, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter M.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Retired"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,3,1]]},"reference":[{"key":"bibr1-j.wem.2019.09.003","unstructured":"United States Geological Survey (USGS). 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