A 17-year-old girl has hundreds of skin lesions on her body that have been forming since childhood. On physical examination, 0.4- to 1.7-cm, macular to slightly raised, plaquelike, dark brown pigmented lesions are present on sunexposed and non-sun-exposed areas of skin. The lesions have irregular contours, and there is variability in pigmentation. She says that her 15-year-old brother has similar lesions. Which of the following molecular changes are most likely to be present in the DNA from this patient?
□ (A) Deletion of the von Hippel-Lindau (VHL) gene
□ (B) Mutation of the PTCH gene
□ (C) Integration of the human papillomavirus-16 (HPV-16) genome
□ (D) Deletion of the p16/INK4A (CDNK2) gene
□ (E) Microsatellite instability
□ (F) Ultraviolet light-induced damage from pyrimidine dimers
