Foul-smelling, crusty lesions on head, neck, trunk, and groin, and punctate keratosis on soles and palms; lesions can form in zosteriform pattern on chest. Autosomal dominant condition is seen with a variable degree of mental retardation and defects in tonofilament-desmosome complex. Onset is 10Ð20 years of age. Treatment is avoidance of sun exposure (mild cases), etretinate or isotretinoin (moderate cases), or dermabrasion (severe cases).