“…28,29 By contrast, the epidermolytic changes seen in the palmoplantar skin and less pronounced in the oral epithelium of pachyonychia congenita type I are caused by mutations of keratins 6A and 16. [30][31][32] Keratin 16 mutations were also reported in two families with focal nonepidermolytic palmoplantar keratoderma with oral, genital, and follicular lesions. 23,24 The absence of epidermolysis in this syndrome is thought to be caused by less disruptive keratin 16 mutations than in type I pachyonychia congenita.…”