TP53 and Leigh syndrome: Rolfe et al. showed that 10 of 12 LS-associated SCCs exhibited a p53 mutation, and in 7 of those 10 cases LS lesions exhibited the p53 mutation at the same codon as in the SCC lesions, suggesting that a p53 mutation is possibly involved early in the HPV-independent pathway of vulvar carcinogenesis [36].