IVL and recessive dystrophic epidermolysis bullosa: Smoller et al. [82] discussed that alterations within the dermis might be responsible for an “activated immunophenotype” state of the epidermis in conditions that predispose to squamous cell carcinomas, including actinic keratoses, defects in wound healing, and RDEB, characterized by expression of involucrin, filaggrin, and other proteins.