The prevalence of human papillomavirus genotypes in nonmelanoma skin cancers of nonimmunosuppressed individuals identifies high-risk genital types as possible risk factors.

Experimentelle Virologie, Universitätsklinikum Tübingen, Eberhard Karls Universitaet Tuebingen, Elfriede Aulhorn Strasse 6, 72076 Tuebingen, Germany.
Cancer Research (Impact Factor: 9.28). 12/2003; 63(21):7515-9.
Source: PubMed

ABSTRACT Nonmelanoma skin cancer is the most commonly diagnosed malignant disease in Caucasians. Known risk factors include fair skin, sun exposure, male gender, advancing age, and the presence of solar keratosis. No viral risk factors have been established thus far. To examine the association between nonmelanoma skin cancer and infection with human papilloma virus (HPV) types, we performed a retrospective study in which skin biopsies were collected from 496 nonimmunosuppressed patients attending dermatologic clinics during a defined period and for whom a biopsy or resection of a tumor was indicated for medical reasons. A total of 390 patients with histologically confirmed diagnosis of warts (n = 209), solar keratosis or Bowen's disease (n = 91), squamous cell carcinoma (n = 72), or basal cell carcinoma (n = 18), as well as 106 control patients with normal skin was analyzed for infection with HPV and, if positive, HPV typed by sequencing. Logistic regression was performed to separately investigate association of certain HPV types with the occurrence of warts, precancerous lesions, and skin cancer compared with normal skin. For all three histological groups, both crude risk and risk adjusted for age, sex, and sun exposure were calculated. HPV DNA was detected in only 4.7% of controls, in 90.9% of benign warts, in 60.4% of precancerous lesions, in 59.7% of squamous cell carcinoma, and in 27.8% of basal cell carcinoma, which demonstrates that viral infection is specifically linked to skin disorders. The distribution of viral types found is distinctly different between warts and precancers or cancers, supporting an etiologic role of specific HPV types. This is supported by statistical analysis, where after adjusting for age, gender, and sun exposure, the odds ratio for nonmelanoma skin cancer in patients who were DNA positive for the high-risk mucosal HPV types, 16, 31, 35, and 51 was 59 (95% confidence interval, 5.4-645) with normal skin as controls. These findings suggest that persistent infections of the skin with high risk genital HPV types recently identified as significant risk factors for cervical cancer may also represent a risk factor for nonmelanoma skin cancer in a nonimmunosuppressed population.

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    ABSTRACT: Anal condylomata are common in HIV-positive individuals and among men who have sex with men (MSM). Generally attributable to infection by low-risk human papillomaviruses (HPVs), condylomata are considered benign low-grade Squamous Intraepithelial Lesions (SILs). However, anal condylomata have occasionally been linked to high-grade SIL and to oncogenic, high-risk HPVs. Here we describe the range of intraepithelial lesions and of the associated HPVs in heterosexual men/women and MSM. Perianal and anal condylomata were collected from 243 patients (56 heterosexual women, 61 heterosexual men and 126 MSM, including 41 HIV-positive MSM). We assessed lesion histology and HPV genotype. Prevalence estimates and Poisson models were used. Irrespective of HIV-infection status, MSM showed higher proportion of condylomata as high-grade SILs compared with heterosexual men/women. High-grade SILs were also more prevalent in anal than in perianal lesions in all patient groups. HIV-positive MSM exhibited increased prevalence ratio [4.6; 95% CI: 2.1-10.0] of perianal low-grade SILs containing only high-risk HPVs compared with HIV-negative MSM. In addition, more than 64% of anal SILs with a high-grade component, regardless of HIV infection, were exclusively associated with low-risk HPVs. In anal condylomata, both high-grade and low-grade SILs can be associated with high-risk and/or low-risk HPVs. Particularly, low-grade perianal SILs associated with high-risk HPVs were common in HIV-positive MSM, while presence of only low-risk HPVs in high-grade SILs were common in both MSM groups. Our findings sound a note of caution for the common clinical practice for the treatment of anal condylomata as benign lesions in MSM and HIV+ patients.
    Clinical Microbiology and Infection 02/2015; in press. DOI:10.1016/j.cmi.2015.02.009 · 5.20 Impact Factor
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    ABSTRACT: Background: Existing epidemiological evidence is controversial regarding the possible association between Beta Human papillomavirus (B-HPV) and cutaneous squamous cell carcinoma (cSCC) in immunocompetent individuals. Objectives: Perform a systematic review of cohort and case-control studies that assessed B-HPV and the risk of cSCC in immunocompetent individuals to assess the current data. Materials and methods: We performed a systematic literature search for studies in humans through March 17, 2014, with no specified start date or language restrictions and employed predefined search criteria. The included studies complied with the predefined inclusion and exclusion criteria and were agreed upon by both authors after review of abstracts and full text. Data extraction included general study information comprising latitude of study location, study design, the number of cases and controls, method of HPV detection and the number of types of HPV detected. Furthermore, study results were designated as the general and/or type specific B-HPV adjusted Odds Ratio or Relative Risk. Results: This is the largest review to be conducted on this topic in healthy individuals. We evaluated 4,056 cSCC cases and 7,067 controls that were collected from 16 casecontrol and 4 cohort studies included in this review. Studies were subdivided into six categories depending on the method of HPV detection used. Among the 20 studies, 18 (90%) showed a significant association between B-HPV and cSCC. More specifically, HPV8 and HPV38 were most commonly reported to have a significant association with cSCC. Conclusion: This systematic review provides further evidence supporting the role of B-HPV in the development of cSCC in healthy individuals and supports a possible type-specific HPV 8, 38 involvements in cSCC. Our findings highlight the need for large multi-center prospective research to validate these associations.

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May 17, 2014