Fig. 1.
Affected individuals showing palmoplantar hyperkeratosis (a, b) with progredient (c) and transgredient (d) spread. Psoriasiform lesions were present over the elbows (e) and knees (f). g A 12-year-old girl at the start of the second cycle of tooth involvement presenting with gingivitis and periodontitis. h A man in his fourth decade with nearly complete loss of his teeth.