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. Author manuscript; available in PMC: 2022 Feb 1.
Published in final edited form as: J Eur Acad Dermatol Venereol. 2020 Jul 23;35(2):396–402. doi: 10.1111/jdv.16767

Figure 5: Three-hit-hypothesis of late-onset BCC development in NBCCS patients.

Figure 5:

Diagram showing a proposed mechanism for late-onset BCC tumor growth in NBCCS patients. From left to right: A keratinocyte carries a heterozygous germline splice site mutation (1st hit). Two additional genetic events, i.e. LOH (2nd hit) and UVR-damage (3rd hit) cause malignant transformation into BCC.