ICAM1 and pachyonychia congenita: Here, a novel precision medicine approach for PC treatment is developed, which is composed of a rationally designed tumor‐targeting ICAM1 antibody‐drug conjugate (ADC) with optimized chemical linker and cytotoxic payload, complemented with a magnetic resonance imaging (MRI)‐based molecular imaging approach to noninvasively evaluate the efficiency of ICAM1 ADC therapy.