Epidermal clones of p53-mutated keratinocytes are abundant in chronically sun-exposed skin and may play an important role in early development of skin cancer. Advanced laser capture microdissection enables genetic analysis of targeted cells from tissue sections without contamination from neighboring cells. In this study p53 gene mutations were characterized in single cells from normal, chronically sunexposed skin. Biopsies were obtained from skin subjected to daily summer sun and skin totally protected from the sun by blue denim fabric. Using laser capture microdissection, 172 single-cell samples were retrieved from four biopsies and analyzed using single-cell polymerase chain reaction and direct DNA sequencing. A total of 14 different mutations were identified in 26 of 99 keratinocytes from which the p53 gene could be amplified. Mutations displayed a typical UV signature and were detected in both scattered keratinocytes and in a small cluster of p53-immunoreactive keratinocytes. This minute epidermal p53 clone had a diameter of 10 to 15 basal cells. Two missense mutations were found in all layers of epidermis within the p53 clone. The presented data show that p53 mutations are common in normal skin and that a clone of keratinocytes with a mutated p53 gene prevailed despite 2 months of total protection from ultraviolet light. 1 Ultraviolet (UV) radiation from the sun is accepted as a major risk factor and tumor cells exhibit mutations with typical UV signature in cancerrelated genes.2 Skin carcinogenesis is a multistep process, in which the early clandestine events, preceding malignant transformation are primarily unknown. In chronically sun-damaged skin SCC develops through stages of actinic keratosis and SCC in situ, whereas no such precursor lesions are known for BCC. Although several genes and pathways are important for development of skin cancer, the genetic events underlying the different steps from a normal cell to SCC or BCC are virtually unknown. Mutation of the p53 gene is one frequent, known genetic alteration found in SCC and BCC. In addition, activation of the sonic hedgehog/patched signaling pathway seems essential for development of BCC. 4,5 In human skin there exists a multitude of p53-immunoreactive clusters of morphologically normal epidermal keratinocytes.6 -8 These p53 clones are predominantly found in chronically sun-exposed skin. Microdissection followed by polymerase chain reaction (PCR) and direct DNA sequencing has shown an underlying p53 mutation in at least 70% of analyzed cases. Epidermal p53 clones and adjacent cancers have never been shown to share the same p53 mutation and thus there is no solid evidence of a genetic link between p53 clones and any specific type of skin cancer.9,10 However, the incidence and location of p53 clones suggest a role for p53 mutations in skin cancer. Mutations in the p53 gene have also been detected in UV-irradiated mouse skin months before the gross appearance of skin tumors, suggesting that p53 mutations are an early event for the development of skin ...