In a study conducted by Jacob et al. (2019), most patients with metastatic PC had mutations in TP53 and were HPV-negative [86] This suggests that TP53 mutations appear to be the main factor associated with metastasis in patients with advanced PC, whereas HPV-related oncogenic mechanisms appear to be more effective in the early stages of the disease and are gradually lost [85, 86]. Here, TP53 is linked to pachyonychia congenita.