• extremely rare
  • autosomal dominant disorder
    • RHBDF2 mutation
  • Clinical features
    •  Focal hyperkeratosis of the palms and soles, with thickening and fissuring of the skin.
    • Oral precursor lesions, such as leukoplakia
    • High risk of developing esophageal cancer 
      • In one study, 95% of patients had esophageal cancer by 65 years of age.
      • Require OGD surveillance from an early age