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(ii) Tumor suppressor gene hotspot nucleotides (nt) reached variant allele frequency (VAF) 0.1%\u201310% via 30\u20133000 fold clonal expansion in occasional biopsies, due to being cancer drivers. (iii) Cyclobutane pyrimidine dimer (CPD) hyperhotspots attained those frequencies in nearly every biopsy, due to profuse creation plus ~30\u2010fold clonal expansion. (iv) Neonatal keratinocyte cultures exposed to weeks of low\u2010dose UVB exposure developed mutations at skin cancer tumor suppressor gene hotspot nt rarely and randomly, as expected. (v) CPD hyperhotspots in gene promoters acquired mutations in days at 1000\u2010fold higher frequencies. Sun exposure is the strongest risk factor for skin cancer, so quantifiable UV signature mutations at CPD hyperhotspots in normal skin may make it technically feasible to identify individuals in need of monitoring to ensure early detection.<\/jats:p>","DOI":"10.1111\/php.70159","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:08:22Z","timestamp":1790140102000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>UV<\/scp>\n                    signature mutation hyperhotspots as genomic dosimeters"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-5035","authenticated-orcid":false,"given":"Vijay","family":"Menon","sequence":"first","affiliation":[{"name":"Department of Therapeutic Radiology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Garc\u00eda\u2010Ruiz","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Radiology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Neveu","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Cartmel","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"},{"name":"Yale Cancer Center, Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah M.","family":"Ferrucci","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"},{"name":"Yale Cancer Center, Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meg","family":"Palmatier","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Radiology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2270-2524","authenticated-orcid":false,"given":"Christine","family":"Ko","sequence":"additional","affiliation":[{"name":"Yale Cancer Center, Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Dermatology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5325-212X","authenticated-orcid":false,"given":"Kenneth Y.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Pathology and Tumor Microenvironment &amp; Metastasis H. 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