TP53 and Hyperkeratosis: There is also an entity known as hyperkeratosis with minimal to no cytologic atypia [keratosis of unknown significance (KUS) or hyperkeratosis, nonreactive (HkNR); ref. 11], which is common among leukoplakia biopsies and may also harbor malignant potential (12); as prior molecular studies suggest genetic overlap between KUS and dysplasia includes frequent alterations in TP53 and KMT2C (13).