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July 1981

Controversy in Genetic Disorders-Reply

Author Affiliations

USAF Keesler, Miss

Winchester, Ky

Arch Dermatol. 1981;117(7):381. doi:10.1001/archderm.1981.01650070004005

In Reply.—  We would like to thank Dr Sybert for her interest in our case report.Dr Sybert stated that the penetrance of koilonychia in the family we described is 100%. We agree that penetrance seems to be 100%, but some clinically unaffected family members have not yet had children. Thus, we used the term "high degree of penetrance" rather than stating the 100% figure.In the family described by us, clinical expression is uniform throughout four generations and involves "all" the nails of hands and feet. Thus, we believed that this family was unusual and warranted our report.In the three cases reviewed and cited by Dr Sybert, the expression of nail involvement was either limited to certain nails or unclear. In the report of Schleutermann et al,1 only fingernails and great toenails were involved. Hellier2 stated that family members had involvement of both hands and feet,

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