Both the skin findings and the deafness are heterogeneous in clinical presentation in these disorders. In some cases the deafness is congenital. In others there is later onset hearing loss of moderate degree. The dermatologic features associated with deafness and GJB2 mutations are also variable: in Vohwinkel syndrome there is diffuse honeycomb hyperkeratosis of palms and soles with typical starfish keratoses on the dorsum. Pseudo-ainhum (constricting bands) and auto-amputation of digits may occur. The skin features of Bart-Pumphrey syndrome include hyperkeratotic plaques over knuckles and the dorsal digital joints (knuckle pads), leukonychia (white nails) and palmoplantar keratoderma. KID syndrome is an ectodermal dysplasia affecting the skin, hearing and vision and testing information is provided separately.