SASH1 and skin carcinoma: SASH1-associated skin dyschromia includes classic DUH and the lentiginous phenotype; it predominantly involves sun-­exposed areas with or without dyschromatosis or concomitant palmoplantar keratoderma and skin carcinoma.20 One patient with DUH and a SASH1 mutation (c.1529G > A) presented with lentigines on the face and hands, which gradually spread to the trunk and extremities, without the involvement of the palms, soles, and mucosa.