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Nearly all basal cell carcinomas (BCCs) show activation of the hedgehog signaling pathway. Mutations in the stem cells promote continuous, ligand-independent activation of the hedgehog signaling pathway, causing continuous cell replication. The hedgehog pathway is also involved in postnatal hair follicle growth. In this normal process, the signaling is intermittent and ligand dependent. The targets for hair growth signaling are stem cells located near the bulge region of the hair bulb. Therefore, stem cells in this same region of the hair follicle might reasonably be considered as the source of BCCs.
Using a sophisticated triple transgenic mouse model, investigators showed that nodular BCCs do indeed arise from hair follicle stem cells or th…