Interestingly, there were a total of five reported SCA34 cases with the c.698C > T variant in ELOVL4, and four of them exhibited EK skin lesions [6, 9, 10] in contrast to the present study where the four individuals did not exhibit EK-related skin lesions despite having the exact same nucleotide variant. Here, ELOVL4 is linked to spinocerebellar ataxia type 34.