Keratins are a family of structurally related proteins that form the intermediate filament cytoskeleton in epithelial cells (1). Keratins are expressed in pairs by epithelial cells in a tissue and cell specific manner (2). The major differentiation specific keratins of the buccal mucosa, nasal, esophageal and anogenital epithelia are cytokeratin 4 and cytokeratn 13 (2). Cytokeratin 4 and cytokeratin 13 form heterodimers in normal epithelial cells (3). In humans, cytokeratin 4 is present in all layers of the epidermis at 10 weeks and gradually disappears (3). Genetic mutations in cytokeratin 4 cause white sponge nevus (WSN), an autosomal dominant disorder that affects noncornified stratified squamous epithelia (4).
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