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Areas of hyperpigmentation and hypopigmentation of the skin develop later in life, and BCC or SCC can develop at an early age.[207] Reports of multiple SCCs in situ have been reported in individuals as young as 16 years.[208] The precise increased risk of skin cancer is not well characterized, but the point prevalence of keratinocyte carcinomas, including both BCC and SCC, is 2% to 5% in young individuals affected by this syndrome.[209] This prevalence is clearly greater than that found in individuals in the same age group in the general population