Above pictures shows an extreme case of pitted keratolysis. It is a superficial skin bacterial infection that commonly effects the soles of feel and less commonly palms of hand. It is characterized by white skin and cluster of punched out pits. It is caused by several bacterial species including corynebacterium, dermatophilus, kytococcus and streptomyces. Bacteria proliferates in moist environment and smell is due to sulfur compounds produced by the bacteria. Treatment requires topical antibiotics such as clindamycin, benzoyl peroxide, fucidin acid.