“…The two largest genetic-association studies of SCC (18) and BCC (22) identified multiple risk loci near pigmentation genes (for SCC SLC45A2, IRF4, TYR, HERC2, DEF8, and RALY; for BCC MC1R, IRF4, TYRP1, HERC2, LPP, and BNC2), supporting the well-established role of lighter pigmentation, and its interaction with UV radiation exposure, in the risk of KC. The association of genetic variants in regions of FOXP1 and IRF4 also implicate Notch signaling (30)(31)(32) in both SCC and BCC susceptibility. Patients with Bloom, Werner, and Rothmund-Thomson syndromes are at increased risk of BCC and SCC, implicating chromosomal instability as another shared KC risk factor (14,15).…”