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Gale A, Merzel Šabović EK, Kaiser DJ, Starbek Zorko M. Acquired epidermodysplasia verruciformis in a renal transplant patient: a case report. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2022. [DOI: 10.15570/actaapa.2022.s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gara S, Jones M, Litaiem N, Hedri H, Rammeh S, Zeglaoui F. Acquired epidermodysplasia verruciformis in renal-transplant recipients. Clin Case Rep 2020; 8:2678-2681. [PMID: 33363803 PMCID: PMC7752617 DOI: 10.1002/ccr3.3251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/08/2020] [Accepted: 07/16/2020] [Indexed: 12/28/2022] Open
Abstract
Acquired epidermodysplasia verruciformis in renal-transplant recipients is associated with a high risk for developing squamous cell carcinoma. An accurate diagnosis and a regular monitoring in this high-risk population must be stressed.
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Affiliation(s)
- Soumaya Gara
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Meriem Jones
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | | | - Hafedh Hedri
- Department of NephrologyCharles Nicolle HospitalTunisTunisia
| | - Soumaya Rammeh
- Department of PathologyCharles Nicolle HospitalTunisTunisia
| | - Faten Zeglaoui
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
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3
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Re-evaluation of epidermodysplasia verruciformis: Reconciling more than 90 years of debate. J Am Acad Dermatol 2017; 76:1161-1175. [PMID: 28196644 DOI: 10.1016/j.jaad.2016.12.035] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 12/31/2022]
Abstract
Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by abnormal susceptibility to cutaneous human beta-papillomavirus infections causing persistent flat warts or pityriasis versicolor-like lesions. This generalized verrucous skin disorder resembles generalized verrucosis, but these 2 conditions are distinguished by differences in clinical manifestation and the human papillomavirus types involved. A breakthrough in our understanding of EV was the discovery that homozygous inactivating mutations in TMC6 (EVER1) and TMC8 (EVER2) determine susceptibility to this disorder; however, they have not solved all EV cases fully. These deficiencies account for 75% of affected individuals, leaving a substantial number of patients without an underlying genetic cause. Recently, it has been revealed that mutations in additional genes (RHOH, MST-1, CORO1A, and IL-7) result in extensive human beta-papillomavirus replication and therefore manifest with an EV-like phenotype. The term "acquired EV" is used to describe an EV-like phenotype that develops in immunocompromised hosts, and the introduction of this entity further aggravates the confusion. Reevaluation of these entities is warranted. Here, we review the available data on this issue, provide up to date information on the major characteristics that differentiate between these seemingly clinically similar disorders, and highlight the different mechanisms involved in each disorder.
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Moscicki AB, Ma Y, Gheit T, McKay-Chopin S, Farhat S, Widdice LE, Tommasino M. Prevalence and Transmission of Beta and Gamma Human Papillomavirus in Heterosexual Couples. Open Forum Infect Dis 2017; 4:ofw216. [PMID: 28480229 PMCID: PMC5414092 DOI: 10.1093/ofid/ofw216] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/21/2016] [Accepted: 10/20/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Beta (β) and gamma (γ) human papillomavirus (HPV) are commonly found on the skin. Few of the β types are associated with nonmelanoma skin cancer. Little is known about transmission patterns of these HPV, specifically in the anogenital (AG) areas. The primary objective of this study was to examine the AG concordance and transmission of β and γHPV types between heterosexual couples. METHODS Archival samples from a previously published study examining concordance of alpha HPV types between couples were tested for β and γHPV. Hand, mouth, and genital samples were obtained 5 times over a 6-week period. RESULTS Of the 21 couples examined, β and γHPV were detected in AG sites in 67% and 30% of men, respectively, and 41% and 25% of women. Positive concordance for β and γHPV was 27% and 20%, respectively, which was greater than the observed concordance between noncouples (10% for βHPV and 4% for γHPV). Transmission rate of βHPV between AG areas was 15.9 (95% confidence interval [CI], 3.3-46.5) per 100 person months for men-to-women at risk and for γHPV was 6.6 (95% CI, .2-36.7). Risks for women-to-men were similar. CONCLUSIONS Beta and γHPV are common in the AG area, and data suggest that they can be sexually transmitted.
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Affiliation(s)
- Anna-Barbara Moscicki
- Department of Pediatrics, Division of Adolescent Medicine, University of California, Los Angeles
| | - Yifei Ma
- Department of Pediatrics, School of Medicine, University of California, San Francisco
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Sepideh Farhat
- Department of Pediatrics, School of Medicine, University of California, San Francisco
| | - Lea E Widdice
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Ohio
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
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5
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Egawa N, Doorbar J. The low-risk papillomaviruses. Virus Res 2016; 231:119-127. [PMID: 28040475 DOI: 10.1016/j.virusres.2016.12.017] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/20/2016] [Accepted: 12/21/2016] [Indexed: 02/07/2023]
Abstract
Human Papillomavirus (HPV) research has been dominated by the study of a subset of Alpha papillomaviruses that together cause almost 5% of human cancers worldwide, with the focus being on the two most prominent of these (HPV16 and 18). These viruses are referred to as 'high-risk' (hrHPV), to distinguish them from the over 200 prevalent HPV types that more commonly cause only benign epithelial lesions. The 'low-risk' (lrHPV) term used to describe this group belies their cumulative morbidity. Persistent laryngeal papillomas, which occur rarely in children and adults, require regular surgical de-bulking to allow breathing. Such infections are not curable, and despite being caused by HPV11 (a lrHPV) are associated with 1-3% risk of cancer progression if not resolved. Similarly, the ubiquitous Beta HPV types, which commonly cause asymptomatic infections at cutaneous sites, can sometimes cause debilitating papillomatosis with associated cancer risk. Recalcitrant genital warts, which affect 1 in 200 young adults in the general population, and even the ubiquitous common warts and verrucas that most of us at some time experience, cannot be reliably eradicated, with treatment strategies advancing little over the last 100 years. The review highlights molecular similarities between high and low-risk HPV types, and focuses on the different pathways that the two groups use to ensure persistent infection and adequate virus shedding from the epithelial surface. Understanding the normal patterns of viral gene expression that underlie lesion formation, and which also prevent loss of the infected basal cells in established lesions, are particularly important when considering new treatment options. Finally, the common requirement for deregulated viral gene expression and genome persistence in development of cancers, unites both high and low-risk HPV types, and when considered alongside viral protein functions, provides us with a working understanding of the mechanisms that underlie HPV-associated pathology.
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Affiliation(s)
- Nagayasu Egawa
- Department of Pathology, Tennis Court Road, University of Cambridge, Cambridge, UK
| | - John Doorbar
- Department of Pathology, Tennis Court Road, University of Cambridge, Cambridge, UK.
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6
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Human papillomaviruses: shared and distinct pathways for pathogenesis. Curr Opin Virol 2015; 14:87-92. [PMID: 26398222 DOI: 10.1016/j.coviro.2015.09.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 12/17/2022]
Abstract
Over 200 types of human papillomaviruses (HPV) have been identified that infect epithelial cells at different anatomic locations. HPVs are grouped into five genera with the alpha and beta viruses being the most commonly studied. Members of the alpha HPV genus infect genital epithelia and are the causative agents of many anogenital cancers. Beta HPVs infect cutaneous epithelia and have been suggested as co-factors in the development of non-melanoma skin cancers. Recent studies have shown that activation of DNA damage pathways is important for the productive life cycle of the alpha HPVs while the beta viruses suppress their activation. These differences likely contribute to the varying types of lesions and malignancies that are associated with these viruses.
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Mendes AD, Bittencourt MDJS, Moure ERD, D'Macêdo CM, Yamaki IN, Araújo DMD. Acquired epidermodysplasia verruciformis in a renal transplant recipient--case report. An Bras Dermatol 2014; 89:144-6. [PMID: 24626660 PMCID: PMC3938366 DOI: 10.1590/abd1806-4841.20142803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 07/01/2013] [Indexed: 12/03/2022] Open
Abstract
A 24-year-old male patient, who underwent kidney transplant six years ago due to
Lupus nephritis, for the last two years presented asymptomatic erythematous scaly
plaques on the abdomen and areas exposed to light. Post-transplantation
immunosuppressive medications included prednisone, mycophenolate sodium and
sirolimus. The histopathologic features were typical for epidermodysplasia
verruciformis. Epidermodysplasia verruciformis is a rare autosomal recessive
genodermatosis with increased susceptibility to specific strains of cutaneous human
papilloma virus. The term ''acquired epidermodysplasia verruciformis'' was recently
introduced to the literature and describes epidermodysplasia verruciformis occurring
in patients with impaired cell-mediated immunity. We report an additional case
associated to immunosuppression after kidney transplantation.
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Affiliation(s)
- Alena Darwich Mendes
- Universidade do Estado do Pará, BelémPA, Brazil, MD, Master's degree in Dermatology from Universidade do Estado do Rio de Janeiro (UERJ) - Assistant Professor of Dermatology at Universidade do Estado do Pará (UEPA) and Head of the Dermatology Service at Centro Universitário do Estado do Pará (CESUPA) - Belém (PA), Brazil
| | - Maraya de Jesus Semblano Bittencourt
- Universidade Federal do Pará, BelémPA, Brazil, MD, Master's degree in Tropical Diseases - Assistant professor of Dermatology at Universidade Federal do Pará (UFPA) and Internship professor of Dermatology at Centro Universitário do Estado do Pará (CESUPA) - Belém (PA), Brazil
| | - Emanuella Rosyane Duarte Moure
- Centro Universitário do Estado do Pará, BelémPA, Brazil, MD, Master's degree in hair and nails from Universidade de São Paulo (USP) - Professor of Dermatology at Centro Universitário do Estado do Pará (CESUPA) - Belém (PA). Brazil
| | - Camila Maria D'Macêdo
- Centro Universitário do Estado do Pará, BelémPA, Brazil, Undergraduate medical student at Centro Universitário do Estado do Pará (CESUPA) - Belém (PA). Brazil
| | - Igor Nagai Yamaki
- Centro Universitário do Estado do Pará, BelémPA, Brazil, Undergraduate medical student at Centro Universitário do Estado do Pará (CESUPA) - Belém (PA). Brazil
| | - Dyandra Moreira de Araújo
- Centro Universitário do Estado do Pará, BelémPA, Brazil, Undergraduate medical student at Centro Universitário do Estado do Pará (CESUPA) - Belém (PA). Brazil
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Egawa N, Kawai K, Egawa K, Honda Y, Kanekura T, Kiyono T. Molecular cloning and characterization of a novel human papillomavirus, HPV 126, isolated from a flat wart-like lesion with intracytoplasmic inclusion bodies and a peculiar distribution of Ki-67 and p53. Virology 2012; 422:99-104. [DOI: 10.1016/j.virol.2011.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 09/27/2011] [Accepted: 10/10/2011] [Indexed: 01/28/2023]
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9
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Orth G. Génétique et sensibilité aux papillomavirus: le modèle de l’épidermodysplasie verruciforme. BULLETIN DE L'ACADÉMIE NATIONALE DE MÉDECINE 2010. [DOI: 10.1016/s0001-4079(19)32253-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Rogers HD, Macgregor JL, Nord KM, Tyring S, Rady P, Engler DE, Grossman ME. Acquired epidermodysplasia verruciformis. J Am Acad Dermatol 2009; 60:315-20. [PMID: 19150275 DOI: 10.1016/j.jaad.2008.08.035] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Revised: 08/15/2008] [Accepted: 08/25/2008] [Indexed: 11/28/2022]
Abstract
Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genodermatosis with an increased susceptibility to specific human papillomavirus (HPV) genotypes. Classically, this viral infection leads to the development of tinea versicolor-like macules on the trunk, neck, arms, and face during childhood, and over time, these lesions can progress to squamous cell carcinoma. More recently, an EV-like syndrome has been described in patients with impaired cell-mediated immunity. We describe two cases of EV-like syndrome in HIV-positive patients, review all previously reported cases of EV in patients with impaired cell-mediated immunity, introduce the term "acquired epidermodysplasia verruciformis" to describe EV developing in the immunocompromised host and examine the limited treatment options for these patients.
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Affiliation(s)
- Heather D Rogers
- Department of Dermatology, Columbia University Medical Center, New York, New York, USA.
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11
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zur Hausen H. Papillomaviruses in the causation of human cancers - a brief historical account. Virology 2009; 384:260-5. [PMID: 19135222 DOI: 10.1016/j.virol.2008.11.046] [Citation(s) in RCA: 999] [Impact Index Per Article: 66.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Accepted: 11/18/2008] [Indexed: 12/11/2022]
Abstract
Approximately 35 years ago a role of human papillomaviruses (HPV) in cervical cancer has been postulated. Today it is well established that this very heterogeneous virus family harbours important human carcinogens, causing not only the vast majority of cervical, but also a substantial proportion of other anogenital and head and neck cancers. In addition, specific types have been linked to certain cutaneous cancers. In females, HPV infections on a global scale account for more than 50% of infection-linked cancers, in males for barely 5%. Vaccines against the high risk HPV types 16 and 18 represent the first preventive vaccines directly developed to protect against a major human cancer (cervical carcinoma). This review will cover some of the historical aspects of papillomavirus research; it tries briefly to analyze the present state of linking HPV to human cancers and will discuss some emerging developments.
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12
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Corbalán-Vélez R, Ruiz-Maciá J, Brufau C, López-Lozano J, Martínez-Barba E, Martínez-Escribano J, Carapeto F. Las células tipo epidermodisplasia verruciforme como marcador histológico de inmunodepresión: revisión de 229 carcinomas espinocelulares. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s0001-7310(08)74675-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Host Defenses Against Human Papillomaviruses: Lessons from Epidermodysplasia Verruciformis. Curr Top Microbiol Immunol 2008; 321:59-83. [DOI: 10.1007/978-3-540-75203-5_3] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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14
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Corbalán-Vélez R, Ruiz-Maciá J, Brufau C, López-Lozano J, Martínez-Barba E, Martínez-Escribano J, Carapeto F. Epidermodysplasia Verruciformis-Like Cells as Histologic Markers of Immunosuppression: Review of 229 Squamous Cell Carcinomas. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s1578-2190(08)70250-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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16
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Orth G. Epidermodysplasia verruciformis: a model for understanding the oncogenicity of human papillomaviruses. CIBA FOUNDATION SYMPOSIUM 2007; 120:157-74. [PMID: 3013521 DOI: 10.1002/9780470513309.ch11] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The first evidence for the oncogenic potential of human papillomaviruses (HPVs) was obtained through the study of epidermodysplasia verruciformis (EV). This rare skin disease is characterized by disseminated, refractor, pityriasis versicolor-like lesions as well as flat wart-like lesions, and by the development of skin carcinomas in about 30% of the patients. EV is a multifactorial disease involving genetic, immunological and extrinsic (actinic) factors, in addition to infection with specific HPV types. A number of HPVs (at least 15 types) have been characterized in benign EV lesions. HPV DNA sequences are regularly detected in EV carcinomas but, in contrast to benign lesions, the types associated with cancers are usually restricted to HPV-5 and, less frequently, HPV-8, an HPV-5-related type. HPV-5 genomes are usually found as free monomeric or oligomeric DNA molecules in EV carcinomas, and frequently contain deletions. This is in contrast with HPV DNA sequences in genital cancers, which are often integrated into the host DNA. Evidence for the transcription of HPV-5 genomes in primary and metastatic EV carcinomas has recently been obtained. The available data indicate that HPV-5 and some HPV-5-related types have an oncogenic potential and play a role in the malignant transformation of EV lesions. Infection by these HPVs must be considered a major risk factor for the development of cancers in EV patients. EV HPV DNA sequences have only rarely been detected in premalignant or malignant lesions of the skin in the general population. This further stresses the role of genetic, immunological and extrinsic factors in the abnormal susceptibility of EV patients to a set of specific HPV types.
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17
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18
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Orth G. Genetics of epidermodysplasia verruciformis: Insights into host defense against papillomaviruses. Semin Immunol 2006; 18:362-74. [PMID: 17011789 DOI: 10.1016/j.smim.2006.07.008] [Citation(s) in RCA: 157] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Accepted: 07/14/2006] [Indexed: 10/24/2022]
Abstract
Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genodermatosis associated with a high risk of skin carcinoma. EV results from an abnormal susceptibility to infection by specific human papillomavirus (HPV) genotypes (beta-papillomaviruses) which include the potentially oncogenic HPV5. EV-specific HPVs are considered as harmless for the general population. EV was recently found to be caused by invalidating mutations in two adjacent, related, novel genes, EVER1/TMC6 and EVER2/TMC8. EVER genes encode transmembrane proteins located in the endoplasmic reticulum, which are likely to function as modifiers of ion transporters or channels and to be involved in signal transduction. It was proposed that EV was a primary defect of innate immunity. Our hypothesis is that EVER proteins act as restriction factors for EV-specific HPVs in keratinocytes, and that EV represents a primary deficiency of intrinsic immunity against certain papillomaviruses.
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Affiliation(s)
- Gérard Orth
- Department of Virology, Institut Pasteur, 25 Rue du Docteur Roux, 75015 Paris, France.
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19
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Kottke MD, Parker SRS. Intravenous cidofovir-induced resolution of disfiguring cutaneous human papillomavirus infection. J Am Acad Dermatol 2006; 55:533-6. [PMID: 16908370 DOI: 10.1016/j.jaad.2006.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Revised: 01/03/2006] [Accepted: 01/06/2006] [Indexed: 10/24/2022]
Abstract
Human papillomavirus infection is one of the most common and most distressing cutaneous diseases in patients with HIV infection. It is also a common, and often therapeutically challenging, infection in individuals who are immunologically competent. A wide range of therapeutic options exists for treating cutaneous human papillomavirus infections, but none is uniformly effective. In this report we describe a man with HIV-1 infection and disfiguring facial verruca vulgaris who demonstrated complete clinical response to intravenous cidofovir. Our report provides further support for the use of intravenous cidofovir as therapy for treatment-resistant and/or widespread cutaneous human papillomavirus infection.
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Affiliation(s)
- Margaret D Kottke
- Emory University School of Medicine, Department of Dermatology, Atlanta, Georgia, USA
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20
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Butani AK, Butani A, Arbesfeld DM, Schwartz RA. Premalignant and early squamous cell carcinoma. Clin Plast Surg 2005; 32:223-35. [PMID: 15814119 DOI: 10.1016/j.cps.2004.11.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Actinic keratosis (AK) is a common sun-induced precancerous neoplasm confined to the epidermis. The AK is the initial manifestation of a continuum of clinical and histologic abnormalities that progresses to invasive squamous cell carcinoma (SCC). Bowen's disease, also known as squamous cell carcinoma in situ, represents early SCC confined to the epidermis. More than half of all SCCs contain p53 tumor suppressor gene mutations. Like SCCs, the vast majority of AKs and Bowen's disease lesions are asymptomatic. Each AK and suspicious lesion should be treated before it progresses to invasive SCC. Destructive modalities, such as cryosurgery using liquid nitrogen and electrodesiccation and curettage, usually performed by a dermatologist, are the mainstays of therapy.
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21
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Tobin E, Rohwedder A, Holland SM, Philips B, Carlson JA. Recurrent 'sterile' verrucous cyst abscesses and epidermodysplasia verruciformis-like eruption associated with idiopathic CD4 lymphopenia. Br J Dermatol 2003; 149:627-33. [PMID: 14511000 DOI: 10.1046/j.1365-2133.2003.05543.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Rupture of follicular (epidermoid) cysts is believed to be the consequence of bacterial infection. We report a 24-year-old man with idiopathic CD4 lymphopenia and chronic Mycobacterium avium intracellulare infection who developed multiple, recurring painful abscesses over the distal extremities that increased in number and severity when systemic steroid and interferon-gamma treatment was instituted for interstitial lung disease. Cultures were consistently negative for microorganisms, but pathological examination revealed ruptured epidermoid cyst walls with human papillomavirus (HPV) viropathic changes (keratinocytes with perinuclear halos and abundant basophilic keratohyaline granules). Cutaneous examination showed numerous, widespread flat-topped papules and achromic macules over the extremities, head and neck. Nested polymerase chain reaction analysis for HPV DNA revealed that the abscess-related cyst walls harboured epidermodysplasia verruciformis (EV)-associated HPV types 20, 24, alb-7 (AY013872) and 80. His cutaneous lesions harboured HPV types 3, 8 and 80. Similar to past reports, our patient developed an EV-like eruption in the setting of immunodeficiency. In this instance, EV-associated HPV infection of the follicular infundibular epithelium or pre-existing cysts in the setting of immunodeficiency may have led to cystic growth, rupture and subsequent painful inflammation.
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Affiliation(s)
- E Tobin
- Upstate Infectious Disease, 567 New Scotland Ave., Albany, NY 12208, USA
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22
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Carré D, Dompmartin A, Verdon R, Comoz F, Le Brun E, Freymuth F, Leroy D. Epidermodysplasia verruciformis in a patient with HIV infection: no response to highly active antiretroviral therapy. Int J Dermatol 2003; 42:296-300. [PMID: 12694498 DOI: 10.1046/j.1365-4362.2003.01707_2.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Delphine Carré
- Services de Dermatologie, Center Hospitalier Universitaire, Caen, France
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23
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Abstract
Human papillomavirus infection remains a great source of morbidity and mortality. Progress in understanding the structure of HPV and its pathogenesis has led to a wide variety of possible new treatment modalities to combat HPV-related disease. Most HPV infections (whether high risk or low risk) resolve without any medical intervention. Persistent or progressive disease, however, remains difficult to treat. Although currently available therapies have proved efficacious and tolerable in the treatment of nongenital and genital warts, no single therapy is uniformly effective in eradicating persistent HPV infection. Cytodestructive methods, such as cryotherapy, remain the primary treatment modality for nongenital warts. Immune response modifiers, such as imiquimod, currently show the greatest promise in treating HPV-induced anogenital lesions, both with respect to complete response and in preventing recurrence. Human papillomavirus infection is one of the most common sexually transmitted diseases in the world, and cervical cancer still causes significant morbidity and mortality. Pap smear tests have greatly reduced the incidence and mortality of cervical cancer in developed countries. Additional research will focus on primary and secondary prevention strategies. Vaccines against high-risk HPV types are promising modalities currently under investigation to prevent HPV infections and possibly to treat them.
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Affiliation(s)
- Mathijs H Brentjens
- Departments of Dermatology, Microbiology/Immunology, and Internal Medicine, University of Texas Medical Branch-Galveston, Galveston, TX, USA
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24
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Affiliation(s)
- A G Sheil
- Department of Surgery, Royal Prince Alfred Hospital, Sydney, Australia
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25
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Harwood CA, Spink PJ, Surentheran T, Leigh IM, Hawke JL, Proby CM, Breuer J, McGregor JM. Detection of human papillomavirus DNA in PUVA-associated non-melanoma skin cancers. J Invest Dermatol 1998; 111:123-7. [PMID: 9665398 DOI: 10.1046/j.1523-1747.1998.00240.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Psoralen and UVA (PUVA) photochemotherapy is associated with a dose-dependent increased risk of nonmelanoma skin cancer in patients treated for psoriasis. Like ultraviolet B radiation, PUVA is both mutagenic and immunosuppressive and may thus act as a complete carcinogen; however, the reversed squamous to basal cell carcinoma ratio (SCC:BCC) in PUVA-treated patients, also seen in immunosuppressed renal transplant recipients, suggests a possible cofactor role for human papillomavirus (HPV) infection. In this study we examine a large series of benign and malignant cutaneous lesions for the presence of HPV DNA from patients treated with high dose (> or =500 J per cm2) ultraviolet A. A panel of degenerate primers based on the L1 (major capsid protein) open reading frame was employed, designed to detect mucosal, cutaneous, and epidermodysplasia verruciformis HPV types with high sensitivity and specificity. HPV DNA was detected in 15 of 20 (75%) non-melanoma skin cancer, seven of 17 (41.2%) dysplastic PUVA keratoses, four of five (80%) skin warts, and four of 12 (33%) PUVA-exposed normal skin samples. The majority of HPV positive lesions contained epidermodysplasia verruciformis-related HPV including HPV-5, -20, -21, -23, -24, and -38. Possible novel epidermodysplasia verruciformis types were identified in further lesions. Mixed infection with epidermodysplasia verruciformis, cutaneous, and/or mucosal types was present in six of 30 (20%) of all HPV positive lesions, including in normal skin, warts, dysplastic PUVA keratoses, and squamous cell carcinomas. The prevalence and type of HPV infection in cutaneous lesions from PUVA-treated patients is similar to that previously reported in renal transplant-associated skin lesions, and suggests that the role of HPV in PUVA-associated carcinogenesis merits further study.
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Affiliation(s)
- C A Harwood
- Department of Academic Dermatology, Royal Hospitals NHS Trust, London, UK
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26
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Abstract
BACKGROUND Actinic keratosis (AK) is a common sun-induced precancerous neoplasm confined to the epidermis. It is the initial manifestation of a continuum of clinical and histologic abnormalities that progresses to invasive squamous cell carcinoma (SCC), a disorder that accounts for thousands of preventable deaths in America each year. OBJECTIVE The purpose of this work is to describe the actinic keratosis. METHODS This effort was performed by a literature review and analysis. RESULTS Like SCCs, the vast majority of AKs are asymptomatic. Although some actinic keratoses may become clinically inapparent, possibly either due to immune rejection or simply having their external surface unknowingly scraped off, an untreated AK represents a potentially curable fatal cancer. CONCLUSIONS Each AK should be treated before it progresses to invasive squamous cell carcinoma. Destructive modalities such as cryosurgery using liquid nitrogen and electrodesiccation and curettage are the mainstays of therapy. Each case must be individualized. LEARNING OBJECTIVES After studying this article, participant should be able to: 1. Understand the concept of an actinic keratosis. 2. Learn how to recognize its clinical manifestations. 3. Be aware of the danger it poses as an easily curable papulonodule that may become a fatal cancer.
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Abstract
Actinic keratoses are extremely common premalignant keratinocytic neoplastic lesions that develop primarily in fair-complexioned individuals during midlife or beyond. Genetic, occupational and other environmental factors predispose to the development of these lesions. Without treatment, a significant number may progress to fully developed neoplasms, especially squamous cell carcinoma, over a period of 20 to 50 years. The multistep theory of carcinogenesis is helpful in understanding the pathogenesis and progression of this important and highly prevalent lesion.
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Affiliation(s)
- J W Barnaby
- Division of Dermatopathology, University of Texas Southwestern Medical Center, Dallas, USA
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28
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Affiliation(s)
- H Pfister
- Institute of Virology, University of Cologne, Germany
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29
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Majewski S, Jabłońska S, Orth G. Epidermodysplasia verruciformis. Immunological and nonimmunological surveillance mechanisms: role in tumor progression. Clin Dermatol 1997; 15:321-34. [PMID: 9255439 DOI: 10.1016/s0738-081x(96)00169-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- S Majewski
- Department of Dermatology, Warsaw School of Medicine, Poland
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30
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Affiliation(s)
- M Favre
- Unité des Papillomavirus, Unité INSERM 190, Institut Pasteur, Paris, France
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31
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Mansat-Krzyzanowska E, Dantal J, Hourmant M, Litoux P, Soulillou J, Drégno B. Frequency of mucosal HPV DNA detection (types 6/11, 16/18, 31/35/51) in skin lesions of renal transplant patients. Transpl Int 1997. [DOI: 10.1111/j.1432-2277.1997.tb00556.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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Webb MC, Compton F, Andrews PA, Koffman CG. Skin tumours posttransplantation: a retrospective analysis of 28 years' experience at a single centre. Transplant Proc 1997; 29:828-30. [PMID: 9123544 DOI: 10.1016/s0041-1345(96)00152-2] [Citation(s) in RCA: 128] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M C Webb
- Renal Unit, Guy's Hospital, London, UK
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33
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Arends MJ, Benton EC, McLaren KM, Stark LA, Hunter JA, Bird CC. Renal allograft recipients with high susceptibility to cutaneous malignancy have an increased prevalence of human papillomavirus DNA in skin tumours and a greater risk of anogenital malignancy. Br J Cancer 1997; 75:722-8. [PMID: 9043031 PMCID: PMC2063341 DOI: 10.1038/bjc.1997.128] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Renal allograft recipients (RARs) have a well-documented increased incidence of viral warts and cutaneous neoplasia, particularly those with long graft life and high sun exposure. A clinicopathological survey of 69 RARs in south-east Scotland, with follow-up periods of up to 28 years after transplantation, revealed marked variation in patient susceptibility to cutaneous malignancy with concomitant variation in HPV prevalence. Skin cancers were found in 34 patients. Eight patients showed high susceptibility [defined as more than four intraepidermal carcinomas (IECs) or invasive squamous cell carcinomas (SCCs)] 42 had intermediate susceptibility (1-3 IECs or SCCs, or >3 keratoses) and 18 had low susceptibility (< or = 3 keratoses and no cancers). SCCs, IECs and keratoses from the high-susceptibility group were found to have greater prevalences of human papillomavirus (HPV) DNA (56%, 45% and 50% respectively), than SCCs (0%) and IECs (33%) from intermediate-susceptibility RARs and keratoses (36%) from the combined intermediate- and low-susceptibility groups and compared with a group of immunocompetent controls (27%, 20% and 15% respectively). No differences in p53 protein accumulation, determined immunohistochemically, were observed in tumours from the three groups. Categorization of RARs by susceptibility to cutaneous malignancy provides clinically useful information, as significantly more high-susceptibility patients (38%) developed aggressive, potentially lethal anogenital or cutaneous squamous cell cancers than did patients in the intermediate group (5%, P=0.005) or the low-susceptibility group (0%).
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Affiliation(s)
- M J Arends
- Department of Pathology, Edinburgh University Medical School, UK
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34
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Höpfl R, Bens G, Wieland U, Petter A, Zelger B, Fritsch P, Pfister H. Human papillomavirus DNA in non-melanoma skin cancers of a renal transplant recipient: detection of a new sequence related to epidermodysplasia verruciformis associated types. J Invest Dermatol 1997; 108:53-6. [PMID: 8980287 DOI: 10.1111/1523-1747.ep12285630] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The detection of human papillomavirus (HPV) types originally isolated from patients with epidermodysplasia verruciformis (EV) in skin tumors of transplant recipients may point to a role of this HPV subgroup in non-melanoma skin cancer in immunosuppressed people. We analyzed 17 formalin-fixed, paraffin-embedded biopsies of benign or malignant skin tumors of a renal transplant patient with unusually widespread cutaneous carcinomas. Using a nested polymerase chain reaction (PCR), HPV-specific DNA was demonstrated in 11 specimens (65%). Analysis of nine PCR amplification products revealed four different sequences related to EV-associated HPVs. Three sequences occurred only in one lesion. In six samples identical sequences were found that differed from all HPV sequences published to date and may therefore represent a novel EV-HPV type, preliminarily labeled RTRX7. RTRX7 was found in benign, premalignant, and malignant skin lesions. Alignments identified HPV12 as the closest relative of RTRX7, both in the DNA (81% homology) and in the amino acid sequence (84% homology).
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Affiliation(s)
- R Höpfl
- Department of Dermatology, University of Innsbruck, Austria
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35
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Abstract
Premalignant keratinocytic keratoses are common, especially in pale-complected persons in whom they appear most often as an actinic keratosis. Although the actinic keratosis has a very low malignant potential, arsenic, tar, thermal, scar, reactional, and radiation keratoses may be more clinically aggressive. This article discusses these premalignant keratinocytic neoplasms.
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Affiliation(s)
- R A Schwartz
- Dermatology and Pathology, UMDNJ-New Jersey Medical School, Newark 07103-2714, USA
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36
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Margolius LP. Kaposi's sarcoma and other malignancies in renal transplant recipients. Transplant Rev (Orlando) 1996. [DOI: 10.1016/s0955-470x(96)80022-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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zur Hausen H. Roots and perspectives of contemporary papillomavirus research. J Cancer Res Clin Oncol 1996; 122:3-13. [PMID: 8543590 DOI: 10.1007/bf01203067] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- H zur Hausen
- Deutsches Krebsforschungszentrum, Heidelberg, Germany
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38
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de Jong-Tieben LM, Berkhout RJ, Smits HL, Bouwes Bavinck JN, Vermeer BJ, van der Woude FJ, ter Schegget J. High frequency of detection of epidermodysplasia verruciformis-associated human papillomavirus DNA in biopsies from malignant and premalignant skin lesions from renal transplant recipients. J Invest Dermatol 1995; 105:367-71. [PMID: 7665914 DOI: 10.1111/1523-1747.ep12320803] [Citation(s) in RCA: 121] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Based on immunologic and epidemiologic data, it is plausible that skin cancer in renal transplant recipients is associated with human papillomaviruses (HPV). At present, conflicting evidence exists concerning the presence of HPV DNA in these cancers. We recently described a nested polymerase chain reaction method that enables the detection of all previously isolated epidermodysplasia verruciformis (EV)-associated HPVs. We now describe the detection of EV-associated HPV DNA in 49 (80%) of 61 biopsies from squamous cell carcinomas, in four (50%) of eight basal cell carcinomas, in 14 (93%) of 15 actinic keratoses, in two (40%) of five cases of Bowen's disease, and in four (57%) of seven keratoacanthomas. HPV DNA typing revealed that all detected HPV types belonged to the EV-associated HPV types. A wide spectrum of EV-associated HPVs was found, including six putative new HPV types. In a high percentage of the lesions more than one HPV type was detected. We often found the same HPV types in different skin biopsies from both malignant and premalignant lesions from the same patient. The high frequency of detection of EV-associated HPV types in biopsies from malignant and premalignant lesions is in agreement with the hypothesis that EV-associated HPVs are involved in the pathogenesis of skin cancer in renal transplant recipients.
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39
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Cheng JY, Sheu LF, Meng CL, Lee WH, Lin JC. Detection of human papillomavirus DNA in colorectal carcinomas by polymerase chain reaction. Gut 1995; 37:87-90. [PMID: 7672688 PMCID: PMC1382774 DOI: 10.1136/gut.37.1.87] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Human papillomaviruses (HPVs) are associated with a number of benign and malignant neoplasms. To substantiate the relationship between HPV DNA and colorectal carcinomas, 70 carcinomas and 37 adenomas were analysed in this study. Specific types of HPV DNA in colorectal tumours were detected by polymerase chain reaction (PCR) and Southern blot hybridisation. HPV DNA was detected in 11 of 37 (29.7%) adenomas and in 52.9% 37 of 70 (52.9%) of carcinomas. The expression of HPV DNA in adenomas and carcinomas, especially that of HPV 16 in HPV positive cases (4 of 11 v 26 of 37), was significantly different (p < 0.05). There was no correlation, however, between HPV and the location, differentiation, stage, or survival of malignant neoplasms. These data suggest that HPV DNA, especially type 16, is associated with colorectal carcinogenesis.
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Affiliation(s)
- J Y Cheng
- Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
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40
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Dyall-Smith D, Ross JB. Cutaneous malignancies in renal transplant recipients from Nova Scotia, Canada. Australas J Dermatol 1995; 36:79-82. [PMID: 7646393 DOI: 10.1111/j.1440-0960.1995.tb00937.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Four hundred and seventy-four Nova Scotian renal transplant recipients were screened, using the records of the Nova Scotia Cancer Registry and the Victoria General Hospital, in a retrospective study, for the development of cutaneous malignancies. Sixteen patients developed a total of 60 squamous cell carcinomas (SCC) and 14 developed 28 basal cell carcinomas (BCC). The survival curve shows that within 10 years of transplant, less than 10% will develop SCC. This is a 16-fold increase above the rate of SCC in the general population of Nova Scotia, Canada. Age at time of transplantation appears to be a significant determinant of subsequent skin cancer risk. None of the previously reported HLA associations was found to hold in this small study. The role of ultraviolet radiation, due to both geographic and lifestyle exposure, is discussed when comparing to other transplant studies.
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Affiliation(s)
- D Dyall-Smith
- Department of Dermatology, Monash Medical Centre, Clayton, Victoria, Australia
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41
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España A, Redondo P, Fernández AL, Zabala M, Herreros J, Llorens R, Quintanilla E. Skin cancer in heart transplant recipients. J Am Acad Dermatol 1995; 32:458-65. [PMID: 7868716 DOI: 10.1016/0190-9622(95)90069-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The frequency of skin cancer in organ transplant recipients is high, up to 15%. OBJECTIVE Our purpose was to determine the incidence of skin cancer in patients who underwent immunosuppression after heart transplantation and to determine the factors important in the appearance of skin cancer. METHODS We studied the frequency of skin cancer in 92 of 111 patients after they underwent heart transplantation between January 1984 and December 1993. RESULTS At least one cutaneous neoplasm (squamous cell carcinoma and/or basal cell carcinoma) developed in 14 patients (15.2%). The basal cell carcinoma to squamous cell carcinoma ratio was 1:1.5. The skin cancer appeared an average of 31.5 months after transplantation; the average was 36 months for squamous cell carcinoma and 25.3 months for basal cell carcinoma. Cumulative risk rose from 4.3% at 1 year up to 43.8% at 7 years after transplantation. The overall incidence of both types of skin cancer was 45.3 per 1000 posttransplant person-years, with an incidence of 25.8 for basal cell carcinoma and 29.1 for squamous cell carcinoma. Most skin cancers developed between 2 and 3 years after transplantation. All patients were exposed to a significant amount of ultraviolet radiation and had skin type II or III. We did not find a significant association between skin cancer and haplotype HLA-A3, HLA-A11, HLA-DR, and the number of mismatches for HLA-B. CONCLUSION We found an increased progressive cumulative incidence of skin cancer in heart transplant recipients for two reasons: (1) immunosuppression and increased exposure to ultraviolet radiation in some patients, and (2) the skin type of certain patients. We emphasize the need for photoprotection in this group of patients and regular skin cancer screening examinations.
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Affiliation(s)
- A España
- Department of Dermatology, University Clinic of Navarra, School of Medicine, Pamplona, Spain
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42
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Pontén J, Adami HO, Bergström R, Dillner J, Friberg LG, Gustafsson L, Miller AB, Parkin DM, Sparén P, Trichopoulos D. Strategies for global control of cervical cancer. Int J Cancer 1995; 60:1-26. [PMID: 7814140 DOI: 10.1002/ijc.2910600102] [Citation(s) in RCA: 172] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- J Pontén
- Department of Pathology, Uppsala University, Sweden
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43
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Leigh IM, Glover MT. Skin cancer and warts in immunosuppressed renal transplant recipients. Recent Results Cancer Res 1995; 139:69-86. [PMID: 7597313 DOI: 10.1007/978-3-642-78771-3_6] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Non-melanoma skin cancer (NMSC) is increasingly recognised as a complication of long-term immunosuppression and has been particularly studied in renal transplant recipients (RTR). A population study of renal transplant recipients has been performed with analysis of those features contributing to a high rate of detection of NMSC, such that 40% patients with fair skin have NMSC 5 years after transplantation. 90% of the total patient population have warts 5 years after transplantation, many being atypical and in sun-exposed sites. Therefore, contributory factors in these patients include not only the global immunosuppression, ultraviolet radiation (UVR)-induced mutagenesis and photoimmunosuppression, but also the widespread presence of human papillomavirus (HPV) infection, including the unusual epidermodysplasia verruciformis (EV)-associated cutaneous oncogenic HPV.
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MESH Headings
- Adult
- Aged
- Carcinoma in Situ/epidemiology
- Carcinoma in Situ/etiology
- Carcinoma in Situ/immunology
- Carcinoma in Situ/therapy
- Carcinoma in Situ/virology
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Cocarcinogenesis
- Epidermis/pathology
- Epidermis/radiation effects
- Female
- Follow-Up Studies
- Genital Neoplasms, Female/epidemiology
- Genital Neoplasms, Female/etiology
- Genital Neoplasms, Male/epidemiology
- Genital Neoplasms, Male/etiology
- Humans
- Immunocompromised Host
- Immunosuppression Therapy/adverse effects
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/surgery
- Kidney Transplantation
- Leukoplakia, Oral/complications
- Leukoplakia, Oral/epidemiology
- Male
- Middle Aged
- Mouth Neoplasms/epidemiology
- Mouth Neoplasms/etiology
- Neoplasms, Radiation-Induced/epidemiology
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/pathology
- Occupational Exposure
- Papillomaviridae/isolation & purification
- Papillomaviridae/pathogenicity
- Papillomavirus Infections/complications
- Papillomavirus Infections/epidemiology
- Postoperative Complications/epidemiology
- Postoperative Complications/etiology
- Postoperative Complications/pathology
- Prevalence
- Risk Factors
- Skin Diseases/epidemiology
- Skin Diseases/etiology
- Skin Diseases/pathology
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Sunlight/adverse effects
- Tumor Virus Infections/complications
- Tumor Virus Infections/epidemiology
- Ultraviolet Rays/adverse effects
- Warts/epidemiology
- Warts/etiology
- Warts/pathology
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Affiliation(s)
- I M Leigh
- Department of Dermatology, Royal London Hospital Trust, UK
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44
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45
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46
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Affiliation(s)
- J M McGregor
- Department of Dermatology, Royal Free Hospital, London, UK
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47
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Abstract
Solar keratoses (SKs) or actinic keratoses are common dysplastic epidermal lesions which occur in pale-skinned individuals who are chronically exposed to intense sunlight. Together with basal cell carcinomas and squamous cell carcinomas, they constitute a major public health problem in such individuals. Reported SK prevalence rates range from 11 to 25% in various northern hemisphere populations, and amongst Australian adults the range is from 40 to 60%. In the only study to date reporting SK incidence data, 60% of subjects aged 40 years and over with SKs at baseline developed new lesions during 12 months of follow-up, compared with only 19% of those who were lesion-free on the first examination. Because existing epidemiological data on SKs are sparse, very little is known of their natural history, their role in carcinogenesis, or their preventability. In this review, current knowledge about the aetiology, diagnosis, and occurrence of SKs is discussed, as is the need for prospective studies in unselected communities. With accurate baseline data, public health authorities should be in a better position to determine the best preventive strategies, and to evaluate the effectiveness of these programmes.
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Affiliation(s)
- C A Frost
- Department of Epidemiology, Queensland Institute of Medical Research, Herston, Australia
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48
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Han R, Breitburd F, Marche PN, Orth G. Analysis of the nucleotide sequence variation of the antigen-binding domain of DR alpha and DQ alpha molecules as related to the evolution of papillomavirus-induced warts in rabbits. J Invest Dermatol 1994; 103:376-80. [PMID: 7915746 DOI: 10.1111/1523-1747.ep12395285] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We previously found that regression of skin warts induced by the Shope cottontail rabbit papillomavirus in New Zealand White rabbits, as well as malignant conversion of persistent warts, are linked to a restriction fragment length polymorphism of the major histocompatibility complex class II DR alpha and DQ alpha genes. To find out whether this immunogenetic control could be connected with the antigen binding and presentation function of the alpha 1 domain of class II molecules, we have sequenced the exon 2 of the four DR alpha EcoRI and six of the seven DQ alpha PvuII restriction fragment length polymorphism alleles identified, and deduced the encoded amino acid sequences. We found no amino acid polymorphism among DR alpha alleles, indicating that the alpha 1 domain of the DR alpha chain does not condition wart regression or cancer development. In contrast, 27 of the 82 amino acids of the DQ alpha 1 domain were found variable, defining five amino acid sequence alleles. The restriction fragment length polymorphism allele linked to regression and another allele not linked to regression share the same alpha 1 domain, indicating that wart regression is rather conditioned by a closely linked gene. The most divergent DQ alpha 1 allele, however, was that associated with a higher risk of cancer. Alignment of rabbit and human DQ alpha exon 2 alleles disclosed that amino acid charge variations occur at positions assumed to be important for peptide binding in humans. By modulating the affinity for tumor-specific antigenic peptides, such transitions could affect immune surveillance and, thus, condition the risk for progression to carcinoma of papillomavirus-associated lesions.
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Affiliation(s)
- R Han
- Unité des Papillomavirus, INSERM U.190, Paris, France
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49
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Tieben LM, Berkhout RJ, Smits HL, Bouwes Bavinck JN, Vermeer BJ, Bruijn JA, Van der Woude FJ, Ter Schegget J. Detection of epidermodysplasia verruciformis-like human papillomavirus types in malignant and premalignant skin lesions of renal transplant recipients. Br J Dermatol 1994; 131:226-30. [PMID: 7917987 DOI: 10.1111/j.1365-2133.1994.tb08496.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
To evaluate the putative role of human papillomaviruses (HPV) in the development of skin cancer in renal transplant recipients, a series of skin biopsies from premalignant and malignant skin lesions was analysed using the polymerase chain reaction. Four different consensus primer pairs were used. HPV DNA was detected in five of 24 cases of squamous cell carcinoma, in one of three cases of Bowen's disease, in none of four basal cell carcinomas, in two of seven cases of actinic keratosis and in one of five cases of keratoacanthoma. Typing by direct sequencing of the amplified HPV DNA was possible in seven of nine cases, and revealed epidermodysplasia verruciformis (EV)-associated HPV types, or HPV types related to EV-associated types. Hence, HPV DNA could be detected in a significant proportion of (pre)malignant skin tumours in renal transplant recipients. The finding that some of the detected HPV types were as yet uncharacterized EV-related types, suggests that HPV DNA could be present in a higher percentage of lesions, and might be detected with refinement of the techniques.
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Affiliation(s)
- L M Tieben
- Department of Dermatology, University Hospital Leiden, The Netherlands
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50
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Chambers MA, Wei Z, Coleman N, Nash AA, Stanley MA. "Natural" presentation of human papillomavirus type-16 E7 protein to immunocompetent mice results in antigen-specific sensitization or sustained unresponsiveness. Eur J Immunol 1994; 24:738-45. [PMID: 8125141 DOI: 10.1002/eji.1830240337] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We have used a mouse model that utilizes the exclusively epithelial nature of human papillomavirus (HPV) infections to investigate the in vivo immune response to the E7 protein of human papillomavirus type-16. A keratinocyte cell line expressing E7 protein has been established and grafted onto syngeneic mice using a transplantation technique that permits the reformation of a differentiated epithelium on a granulation tissue bed. In this way viral antigens may be presented to the immune system in a way comparable to natural infection. A delayed-type hypersensitivity (DTH) response was studied post grafting by intradermal challenge with recombinant E7 protein. A significant response to E7 has been demonstrated in this way; however, priming with a low amount of HPV-16 E7 antigen induces immunological unresponsiveness, as measured by a loss of DTH reactivity to the protein, and persistence of keratinocytes expressing E7. Lymphocytes from mice exhibiting DTH reactivity have been shown to proliferate when stimulated with purified recombinant E7 protein in vitro, while immunoperoxidase staining of tissue from the sites of immunologically-induced inflammation has defined the cell infiltrate to be phenotypically characteristic of DTH. The observations reported here have important implications for vaccine strategy.
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Affiliation(s)
- M A Chambers
- Department of Pathology, University of Cambridge
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