Evidence of how the skin microbiome directly influences cutaneous antiviral immunity is also limited, although studies in patients with primary immunodeficiency, such as dedicator of cytokinesis 8 (DOCK8) deficiency who have altered cutaneous microbiomes compared to healthy patients, reveal that changes in the cutaneous virome lead to increased colonization of DNA viruses like HPVs, HSVs, polyomaviruses, and MCV (189). Here, DOCK8 is linked to hyperinsulinemic hypoglycemia, familial, 4.