In this well conducted study, a combination of four miRNAs (miR-1246, miR-4644, miR-3976, and miR-4306) and five proteins (CD44v6, Tspan8, EpCAM, MET and CD104) in circulating exosomes was able to distinguish PC patients from non-cases ones, with a sensitivity of 1.0 (CI: 0.95-1) and a specificity of 0.80 (CI: 0.67-0.90). This evidence concerns the gene ITGB4 and pachyonychia congenita.