Case of Dr 

53 year old female with classic features of Nevoid basal cell carcinoma syndrome.
Following are pictures palmar-plantar pits and some reading from UpToDate
Palmar-plantar pits
Palmar and/or plantar pits are highly characteristic of NBCCS, occurring in approximately 80 percent of affected individuals [37,67]. They are asymptomatic nonpalpable shallow depressions (1 to 3 mm) in the skin of the palm and/or soles that are due to partial or complete absence of stratum corneum (figure 1). They may also be found on the sides, web spaces, and dorsum of the fingers and toes [68]. The differential diagnosis should consider punctate keratoderma, pitted keratolysis, and palmar pits of Darier's disease, but the clinical distinction is usually easy.

Pitting generally develops during the patient's 20s and later, but has been reported in much younger patients [50]. In contrast to BCC, there is no racial difference in the frequency of pitting in affected patients with NBCCS [34]. The number of pits is variable but can reach more than 500 in number, particularly in older individuals [68]. They are permanent, and do not wax and wane over time. Soaking the hands in water for 10 to 15 minutes can make their appearance more pronounced [3].

Related Links:
Dermnet on Basal cell nevus syndrome

Frequency of clinical features seen in the Basal cell Nevus Syndrome