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Licata G, Tancredi V, Giorgio CM, Arisi M, Damiani L, Benvenuto P, Moscarella E, Argenziano G. Pigmented nonmelanoma skin cancers of the genital area: a diagnostic and therapeutic challenge - monocentric experience and review of the literature. Int J Dermatol 2024. [PMID: 38840323 DOI: 10.1111/ijd.17286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
Nonmelanoma skin cancers (NMSC), comprising basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are typically encountered on photo-exposed skin. Nevertheless, several cases of NMSC have been described in covered areas such as the genital region; furthermore, some of these lesions may express a variable degree of pigmentation. Due to the existence of mucosal melanoma, an accurate diagnosis is paramount. In this narrative review, we focused our attention on management and - in particular- diagnosis of pigmented NMSC (pNMSC) located in the genital region, emphasizing the features assessed by dermoscopy and reflectance confocal microscopy. As an implementation, we included data on pNMSC from the Dermatology Unit of the University of Campania Vanvitelli. BCC in the genital region represents only 1% of all BCC cases. It has been supposed that the mutation of patched 1 may lead to the development of BCC even without concomitant UV exposure. Pigmented variants on genitals have seldom been described. More prominent dermoscopic features seem to be blue-gray ovoid nests and arborizing vessels associated with whitish structureless areas. SCC and Bowen's disease (BD) - a variant of in situ SCC - may be encountered in the genital area and are sometimes associated with human papillomavirus (HPV) infection. Pigmented SCC is very rare, and most of the literature is focused on pigmented BD (pBD), which is mainly characterized by gray-brown dots in a linear fashion and glomerular vessels without evident scales. In conclusion, pNMSC is rarely encountered on genitals; evaluation with dermoscopy or other ancillary devices like RCM is important both to exclude benign lesions like seborrheic keratosis and lentigo and to rule out melanoma.
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Affiliation(s)
- Gaetano Licata
- Dermatology Unit, San Antonio Abate Hospital, Trapani, Italy
| | - Vittorio Tancredi
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Caterina M Giorgio
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mariachiara Arisi
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Luca Damiani
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pierfrancesco Benvenuto
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Elvira Moscarella
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
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2
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Kricker A, Weber MF, Pawlita M, Sitas F, Hodgkinson VS, Rahman B, van Kemenade CH, Armstrong BK, Waterboer T. Cutaneous beta HPVs, sun exposure and risk of squamous and basal cell skin cancers in Australia. Cancer Epidemiol Biomarkers Prev 2021; 31:614-624. [PMID: 34933956 DOI: 10.1158/1055-9965.epi-21-1000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/24/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sun exposure causes cutaneous squamous (SCC) and basal cell (BCC) carcinomas. Human papillomavirus (HPV) infection might cause SCC. METHODS We examined associations of beta and gamma HPV infection in skin-swab DNA and serum antibodies with skin cancer risk, and modification of the carcinogenic effects of sun exposure by them, in case-control studies of 385 SCC cases, 832 BCC cases and 1100 controls nested in an Australian prospective cohort study (enrolled 2006-2009). RESULTS Presence of beta-1 and beta-3 HPV DNA appeared to increase risks for SCC and BCC by 30%-40% (P adjusted <0.01). BCC was also associated with genus beta DNA, OR=1.48; 95%CI 1.10-2.00 (P adjusted <0.01). Associations were strengthened with each additional positive beta HPV DNA type: SCC (OR=1.07; 95%CI 1.02-1.12) and BCC (OR=1.06; 95%CI 1.03-1.10), P trend <0.01. Positivity to genus beta or gamma in serology, and genus gamma in DNA, was not associated with either cancer. There was little evidence that any beta HPV type was more strongly associated than others with either cancer. A weaker association of sun-exposure with SCC and BCC in the presence of beta-3 HPVs than in their absence suggests that beta-3 HPVs modify sun exposure's effect. CONCLUSIONS Our substantive findings are at the level of genus beta HPV. Like SCC, BCC risk may increase with increasing numbers of beta HPV types on skin. IMPACT The consistency in our findings that HPV infection may moderate the effects of sun exposure, the main environmental cause of SCC and BCC, merits further investigation.
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Affiliation(s)
- Anne Kricker
- The Daffodil Centre, a joint venture with Cancer Council NSW, Sydney School of Public Health, The University of Sydney
| | - Marianne F Weber
- The Daffodil Centre, a joint venture with Cancer Council NSW, Sydney School of Public Health, The University of Sydney
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center
| | - Freddy Sitas
- Centre for Primary Health Care and Equity, University of New South Wales
| | | | | | | | - Bruce K Armstrong
- School of Population and Global Health, University of Western Australia
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center
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3
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Krendl FJ, Messner F, Bösmüller C, Scheidl S, Cardini B, Resch T, Weissenbacher A, Oberhuber R, Maglione M, Schneeberger S, Öfner D, Margreiter C. Post-Transplant Malignancies following Pancreas Transplantation: Incidence and Implications on Long-Term Outcome from a Single-Center Perspective. J Clin Med 2021; 10:jcm10214810. [PMID: 34768331 PMCID: PMC8584646 DOI: 10.3390/jcm10214810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022] Open
Abstract
Chronic immunosuppression is associated with an increased risk of malignancy. The main objective of this study is to evaluate the incidence and effect of post-transplant malignancies (PTMs) following pancreas transplantation. The 348 first pancreas transplants performed between 1985 and 2015 were retrospectively analyzed in this study. Incidences of PTMs, as well as patient and graft survival, were evaluated. Out of 348 patients, 71 (20.4%) developed a PTM. Median time to diagnosis was 130 months. Thirty-six patients (50.7%) developed skin cancers (four patients with melanoma, 32 with NMSCs). Solid organ malignancy occurred in 25 (35.2%), hematologic malignancy in ten patients (14.1%). Affected patients were transplanted earlier [2000 (IQR 1993−2004) vs. 2003 (IQR 1999−2008); p < 0.001]. No differences in induction therapy were seen, both groups demonstrated comparable patient and graft survival. Pancreas transplant recipients with solid organ and hematologic malignancies had a three- and six-fold increased hazard of death compared to those with skin cancers [aHR 3.04 (IQR 1.17–7.91); p = 0.023; aHR 6.07 (IQR 1.87–19.71); p = 0.003]. PTMs affect every fifth patient following pancreas transplantation. Skin cancers are the most common malignancies accounting for 50% of all PTMs. These results underscore the importance of close dermatologic follow-up.
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4
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Cutaneous Head and Neck Cancers in the High-Risk Immunosuppressed Population. Otolaryngol Clin North Am 2021; 54:397-413. [PMID: 33602516 DOI: 10.1016/j.otc.2020.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The immunosuppressed (IS) population encompasses a diverse cohort of patients to include iatrogenically immunocompromised organ transplant recipients as well as patients with chronic lymphoid malignancies, human immunodeficiency virus/acquired immunodeficiency syndrome, and autoimmune disorders. Cutaneous cancers in this high-risk patient group are clinically distinct from the general immunocompetent population, showing aggressive behavior with associated poor outcomes. This article reviews the pathogenesis, epidemiology, incidence, prognosis, and special considerations required in managing cutaneous cancers in the IS patient population.
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5
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Brancaccio RN, Robitaille A, Dutta S, Cuenin C, Santare D, Skenders G, Leja M, Fischer N, Giuliano AR, Rollison DE, Grundhoff A, Tommasino M, Gheit T. Generation of a novel next-generation sequencing-based method for the isolation of new human papillomavirus types. Virology 2018; 520:1-10. [PMID: 29747121 PMCID: PMC9280450 DOI: 10.1016/j.virol.2018.04.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 01/15/2023]
Abstract
With the advent of new molecular tools, the discovery of new papillomaviruses (PVs) has accelerated during the past decade, enabling the expansion of knowledge about the viral populations that inhabit the human body. Human PVs (HPVs) are etiologically linked to benign or malignant lesions of the skin and mucosa. The detection of HPV types can vary widely, depending mainly on the methodology and the quality of the biological sample. Next-generation sequencing is one of the most powerful tools, enabling the discovery of novel viruses in a wide range of biological material. Here, we report a novel protocol for the detection of known and unknown HPV types in human skin and oral gargle samples using improved PCR protocols combined with next-generation sequencing. We identified 105 putative new PV types in addition to 296 known types, thus providing important information about the viral distribution in the oral cavity and skin.
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Affiliation(s)
| | | | | | - Cyrille Cuenin
- International Agency for Research on Cancer, Lyon, France
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Girts Skenders
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Nicole Fischer
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research, partner site Hamburg, Borstel, Lübeck, Riems, Germany
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana E Rollison
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Adam Grundhoff
- German Center for Infection Research, partner site Hamburg, Borstel, Lübeck, Riems, Germany; Heinrich-Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | | | - Tarik Gheit
- International Agency for Research on Cancer, Lyon, France.
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6
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Puza CJ, Myers SA, Cardones AR, Beasley GM, Mosca PJ. The impact of transplant rejection on cutaneous squamous cell carcinoma in renal transplant recipients. Clin Exp Dermatol 2018; 44:265-269. [PMID: 29952022 DOI: 10.1111/ced.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The incidence of cutaneous squamous cell carcinoma (cSCC) is markedly increased in renal transplant recipients compared with that of the nontransplant population. AIM To investigate whether there is a relationship between transplant rejection and cSCC. METHODS The Duke Enterprise Data Unified Content Explorer historical database was used to identify patients who had undergone a renal transplant at Duke University Hospital during a 20-year period. Data on patient demographics, transplant dates, first rejection episodes, first cSCC development, medication, laboratory results and survival were recorded. RESULTS In total, 1684 patients were identified, of whom 126 (7.5%) experienced an episode of rejection and 46 (4.0%) developed a cSCC after transplant. The incidence of cSCC was significantly greater in the rejection group, with 8.7% of patients developing cSCC compared with 2.2% in the no-rejection group (P < 0.001). Median lag time to cSCC was shorter in the rejection group (2.5 years; age 0.4-9.0 years) than the no-rejection group (4.2 years; range 1.3-20.4 years) (P < 0.03). CONCLUSIONS Transplant rejection is associated with both a higher incidence and an accelerated time course for development of cSCC following renal transplantation. Close dermatological surveillance should be considered following an episode of rejection in this patient population.
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Affiliation(s)
- C J Puza
- Duke University School of Medicine, Durham, NC, USA
| | - S A Myers
- Department of Dermatology, Duke Medical Center, Durham, NC, USA
| | - A R Cardones
- Department of Dermatology, Duke Medical Center, Durham, NC, USA
| | - G M Beasley
- Department of Surgery, Duke Medical Center, Durham, NC, USA
| | - P J Mosca
- Department of Surgery, Duke Medical Center, Durham, NC, USA
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7
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Wang YJ, Tang TY, Wang JY, Huang YK, Wu YH. Genital basal cell carcinoma, a different pathogenesis from sun-exposed basal cell carcinoma? A case-control study of 30 cases. J Cutan Pathol 2018; 45:688-695. [PMID: 29920730 DOI: 10.1111/cup.13304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/24/2018] [Accepted: 06/12/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Genital basal cell carcinoma (BCC) accounts for <1% of all BCCs. We aimed to elucidate the pathogenesis of genital BCC. METHODS We retrospectively evaluated cases of pathologically diagnosed genital BCC between 1990 and 2016 in an Asian tertiary referral center. The control group was composed of consecutive cases, from 2016, of BCCs occurring in sun-exposed areas. Presence of human papillomavirus (HPV) was evaluated by polymerase chain reaction (PCR). Immunohistochemical p16 and p53 staining was performed and analyzed. RESULTS We found 33 genital BCCs (33/1837, 1.8%) over 26 years. The mean follow-up duration was 30.0 ± 33.2 months. Genital BCCs had a larger size (14.05 vs 8.92 mm, P = 0.014), more common presence of ulcers (61.3% vs 32.0%, P = 0.035), shorter epidermal p53 clone (0.33 vs 1.20 mm, P = 0.007), and high p53 expression levels. Most cases (29/30, 96.7%) showed negative or faint spotty p16 staining. Patient age, tumor depth, presence of pigment, or histology subtype did not differ significantly. Thirty genital BCCs were negative for HPV. CONCLUSIONS HPV infection is mostly likely not involved in genital BCC pathogenesis. A greater level of p53 expression in genital BCCs implicates pathways other than ultraviolet (UV)-specific p53 mutations in their pathogenesis.
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Affiliation(s)
- Yen-Jen Wang
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tzu-Yin Tang
- Department of Pathology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Jen-Yu Wang
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Kai Huang
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu-Hung Wu
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
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8
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Mittal A, Colegio OR. Skin Cancers in Organ Transplant Recipients. Am J Transplant 2017; 17:2509-2530. [PMID: 28556451 DOI: 10.1111/ajt.14382] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 05/05/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023]
Abstract
Long-term utilization of immunosuppression in organ transplant recipients (OTRs) leads to decreased immune-mediated tumor surveillance and development of malignant tumors. A delicate balance needs to be maintained in the intensity of immunosuppression to keep the risk of malignancy low without jeopardizing life-saving graft function. OTRs are prone to developing skin cancers that exhibit unique epidemiologic, pathophysiologic, and prognostic characteristics. In this review, we discuss the most commonly reported skin cancers in OTRs: squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Kaposi sarcoma, Merkel cell carcinoma, and malignant melanoma (MM). Tumors in this high-risk population are aggressive and may respond poorly to standard therapies; however, new targeted therapies are promising. Checkpoint inhibitor antibodies have been used for treatment of cutaneous SCC, Merkel cell carcinoma, and MM; epidermal growth factor receptor inhibitors have been used for cutaneous SCC; hedgehog pathway inhibitors have been used for BCC; and BRAF and MEK inhibitors are being used increasingly in the management of MM. Guidelines for dermatologic screening are variable and primarily based on expert opinion. Prospective evidence-based trials by multidisciplinary groups are needed to better define surveillance schedules for pre- and posttransplant cutaneous malignancies.
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Affiliation(s)
- A Mittal
- Departments of Dermatology, Yale University School of Medicine, New Haven, CT
| | - O R Colegio
- Departments of Dermatology, Yale University School of Medicine, New Haven, CT.,Departments of Pathology, Yale University School of Medicine, New Haven, CT.,Departments of Surgery, Yale University School of Medicine, New Haven, CT.,Yale Cancer Center, Yale University School of Medicine, New Haven, CT.,Yale-New Haven Transplantation Center, Yale University School of Medicine, New Haven, CT
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9
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Nichols AJ, Allen AH, Shareef S, Badiavas EV, Kirsner RS, Ioannides T. Association of Human Papillomavirus Vaccine With the Development of Keratinocyte Carcinomas. JAMA Dermatol 2017; 153:571-574. [PMID: 28196178 DOI: 10.1001/jamadermatol.2016.5703] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Importance Keratinocyte carcinomas (KCs), consisting of squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs), are the most common human malignant neoplasms. Several risk factors have been implicated in KC development. For some SCCs, particularly those in immunocompromised patients, human papillomavirus (HPV) may be an important factor. Objective To determine whether quadrivalent HPV vaccination would affect the development of KCs in immunocompetent patients with a history of multiple KCs. Design, Setting, and Participants Two patients with a history of multiple KCs-a man in his 70s (patient 1) and a woman in her 80s (patient 2)-were treated in a private dermatology practice. Each patient received 3 doses of the quadrivalent HPV vaccine at 0, 2, and 6 months in 2013, and both patients underwent full-body skin examinations at least every 3 months. Biopsy-proven skin cancers were recorded for 16 months (for patient 1) or 13 months (for patient 2) after the first dose of vaccine and then compared with the number of biopsy-proven skin cancers recorded over a similar period before the first dose of vaccine. The period of observation was from October 18, 2011, to June 21, 2014. Main Outcomes and Measures The numbers of new SCCs and BCCs after the first dose of the quadrivalent HPV vaccine. Results Patient 1 had a mean of 12 new SCCs and 2.25 new BCCs per year before vaccination. After vaccination, he developed 4.44 SCCs and 0 BCCs per year, a 62.5% reduction in SCCs and a 100% reduction in BCCs. Patient 2 had a mean of 5.5 new SCCs and 0.92 new BCCs per year before vaccination. After vaccination, she developed 1.84 SCCs and 0 BCCs per year, a 66.5% reduction in SCCs and a 100% reduction in BCCs. The quadrivalent HPV vaccine was well tolerated by both patients and had no adverse effects. Conclusions and Relevance A reduction of SCCs and BCCs was observed in 2 patients after administration of the quadrivalent HPV vaccine. These findings highlight the possibility that cutaneous SCC development, and perhaps BCC development, may be driven in part by HPV in immunocompetent patients. Human papillomavirus vaccination may represent an efficacious, cost-effective, readily available, and well-tolerated strategy for preventing KCs.
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Affiliation(s)
- Anna J Nichols
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | | | | | - Evangelos V Badiavas
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Robert S Kirsner
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Tim Ioannides
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida4Treasure Coast Dermatology, Port St Lucie, Florida
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10
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Vitiello V, Burrai GP, Agus M, Anfossi AG, Alberti A, Antuofermo E, Rocca S, Cubeddu T, Pirino S. Ovis aries Papillomavirus 3 in Ovine Cutaneous Squamous Cell Carcinoma. Vet Pathol 2017; 54:775-782. [PMID: 28494708 DOI: 10.1177/0300985817705171] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Squamous cell carcinoma (SCC) is a common malignancy affecting humans and other animals. Papillomaviruses (PVs) are frequently reported as causal agents of cutaneous benign and malignant epithelial lesions in different animal species, but only few studies have investigated their role in ovine SCC. In this study, we explore the possible involvement of the Ovine aries PVs (OaPV1, OaPV2, OaPV3) in cutaneous SCC using an integrated histological and molecular approach. Forty cutaneous SCCs from different anatomical locations of Sardinian sheep and 40 matched non-SCC samples were evaluated histologically and by polymerase chain reaction (PCR) to assess the presence of ovine PVs. In addition, DNA in situ hybridization (ISH) and reverse transcription-polymerase chain reaction (RT-PCR) were carried out to evaluate the cellular localization and viral transcriptional activity, respectively. OaPV3 DNA was detected in 26 of 40 (65%) SCCs and in 12 of 40 (30%) non-SCC samples using PCR. OaPV1 and OaPV2 were not detected. OaPV3 viral DNA was observed by ISH in malignant epithelial squamous cells of 18 of 40 (45%) SCCs. In addition, the viral transcriptional activity was identified in 24 of 40 (60%) SCCs by RT-PCR. Notably, a higher viral positivity was observed in SCCs compared with non-SCC samples. The considerable infection rate of OaPV3 in the most common skin tumor of the sheep suggests that PV could represent a key factor in the onset of ovine SCC.
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Affiliation(s)
- Veronica Vitiello
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
| | - Giovanni P Burrai
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
| | - Mariagrazia Agus
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
| | - Antonio G Anfossi
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
| | - Alberto Alberti
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
| | | | - Stefano Rocca
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
| | - Tiziana Cubeddu
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
| | - Salvatore Pirino
- 1 Department of Veterinary Medicine, Sassari University, Sassari, Italy
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11
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Correa RM, Vladimirsky S, Heideman DAM, Coringrato M, Abeldaño A, Olivares L, Del Aguila R, Alonio LV, Snijders PJF, Picconi MA. Cutaneous human papillomavirus genotypes in different kinds of skin lesions in Argentina. J Med Virol 2016; 89:352-357. [PMID: 27420901 DOI: 10.1002/jmv.24631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2016] [Indexed: 12/13/2022]
Abstract
Cutaneous human papillomaviruses (HPVs) comprise a large and highly heterogeneous virus group. Some of the cutaneous HPVs of the genus Beta have been suggested as a co-factor in the development of non-melanoma skin cancer (NMSC). The aim of this study was to determine cutaneous HPV prevalence and type-specific distribution in different kinds of skin lesions from Argentine patients visiting Dermatology Departments of three hospitals from Buenos Aires. A cross-sectional analysis was performed. HPV DNA was analyzed in (i) 3 patients with Epidermodysplasia verruciformis (EV) harboring benign lesions (BL) (n = 1) and squamous cell carcinoma (SCC) (n = 4); (ii) 240 non-EV patients harboring: (a) BL (n = 38), (b) Actinic Keratosis (AK) (n = 83), (c) SCC (n = 74), and (d) basal cell carcinoma (BCC) (n = 96). Detection and genotyping of 35 cutaneous HPV DNA was carried out by BGC-PCR and GP5+/6 + PCR followed by reverse line blot assay. In EV patients, Beta types were found in all lesions (5/5), including the potentially high-risk HPV types 5 and 8, mostly in multiple infections. In non-EV patients, cutaneous types were found in 50.0% of BL, 43.4% of AK, 31.1% of SCC, and 16.7% of BCC. Beta HPVs were the most frequently found in all lesions, being present in all AK and SCC cases that were positive for HPV. No type-specific correlation with lesion severity was found. In our series, a wide spectrum of cutaneous HPV types was detected in different skin lesions. A possible role for these HPVs in skin carcinogenesis deserves further study. J. Med. Virol. 89:352-357, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Rita Mariel Correa
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Sara Vladimirsky
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | | | | | - Alejandra Abeldaño
- Hospital General de Agudos "Dr. Cosme Argerich", Buenos Aires, Argentina
| | | | | | - Lidia Virginia Alonio
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Peter J F Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - María Alejandra Picconi
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
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12
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Nahidi Y, Meibodi NT, Meshkat Z, Esmaili H, Jahanfakhr S. No Evidence of Human Papilloma Virus Infection in Basal Cell Carcinoma. Indian J Dermatol 2015; 60:356-9. [PMID: 26288402 PMCID: PMC4533532 DOI: 10.4103/0019-5154.160479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Basal cell carcinoma (BCC) is the most common skin cancer among whites, and several risk factors have been discussed in itsdevelopment and progress. Detection of human papilloma virus (HPV) deoxyribonucleic acid (DNA) BCCs in some studies suggests that the virus may play a role in the pathogenesis of this disease. Several molecular studies showed conflicting reports. Aims: The purpose of this study was to investigate the association between HPV and BCC using polymerase chain reaction (PCR). Materials and Methods: HPV DNA detection was done for 42 paraffin-embedded tissue specimens of BCC and 42 normal skin samples around the lesions by PCR using GP5+/GP6+ primers. Results: HPV DNA was not found in any of the 42 samples of BCC, and only one normal skin sample around the lesions was positive for HPV DNA by PCR. Conclusion: In this study, no statistically significant difference was seen between the presence of HPV DNA in BCC and normal skin around the lesion, and HPV is not likely to have an important role in pathogenesis of BCC.
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Affiliation(s)
- Yalda Nahidi
- Department of Dermatology, Emam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naser Tayyebi Meibodi
- Department of Pathology, Emam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Meshkat
- Department of Virology, Research Center for Microbiology and Virology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaili
- Department of Faculty of Health, Emam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samaneh Jahanfakhr
- Department of Pathology, Emam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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13
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Ziari K, Behdad B, Mohammadshahi A, Pirasteh HR, Sharifi MD, Dadpay M. Cellular and biological evaluation and diagnostic immunohistochemistry of cytokeratin 15/19 expression in distinguishing cutaneous basal cell carcinoma. Biologicals 2015; 43:181-5. [PMID: 25748637 DOI: 10.1016/j.biologicals.2015.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/19/2022] Open
Abstract
Recent studies have investigated the expression of proliferative markers, but little is known about the expression of cytokeratin 15 and 19 in different histological subtypes of basal cell carcinoma (BCC). We conducted cellular, biological, clinicopathological and immunohistochemical analysis on the manifestations of 8 BCC by hematoxylin and eosin stain (H&E) staining and immunohistochemistry and reviewed relevant literature. Microscopically, the tumor cells were multiple remarkable foci of epidermolytic hyperkeratosis with large pleomorphic nuclei and scant cytoplasm together with peripheral palisading and forming solid nests. Furthermore, the most tumors were composed of highly cellular areas with a homogenous population of round, ovoid and spindle cells, hyperchromatic nuclei, high cellular pleomorphism, high mitotic index and various morphologic patterns. Moreover, the tumors displayed an invasive growth, with positive expression of Cytokeratin 19 (CK19) and negative expression of CK15. Our study revealed that the expression of CK19 was associated with progression and invasion in cases with BCC and immunohistochemistry is indispensable in distinguishing this tumor from other types of cutaneous carcinoma. To our best knowledge, it may be a considerable biomarker to assess invasiveness of cutaneous-surface BCC and to guide clinical management of such tumors.
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Affiliation(s)
- Katayoun Ziari
- Department of Pathology, Be'sat Hospital, AJA University of Medical Sciences, Tehran, Iran
| | - Behnoosh Behdad
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Mohammadshahi
- Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Davood Sharifi
- Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoomeh Dadpay
- Department of Pathology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran.
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14
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Mechanisms of carcinogenesis in human skin against the background of papillomavirus infection. Bull Exp Biol Med 2014; 157:628-33. [PMID: 25257428 DOI: 10.1007/s10517-014-2631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Indexed: 10/24/2022]
Abstract
The cells in the skin tumor developing under conditions of persisting papillomavirus infection are morphologically identical to blast cells in a blood smear from a leukemia patient. The cells filling the lesion focus are morphologically and immunohistochemically related to blood stem cells. A mechanism of epithelial layer modification under conditions of papillomavirus infection leading to carcinogenesis is proposed. The dynamics of structural changes in the skin is characterized by disturbed interactions between the epithelium and adjacent connective tissue, destruction of the basal membrane, disorders in the cambial keratinocyte differentiation, and absence of the spinous and granular layers. We conclude that detection of blast leukocytes in the human skin lesion can be explained by disorders in the cell-cell interactions in the epithelium-mesenchymal tissue system. High proliferative activity followed by death of cambial keratinocytes, migration of effector antigen-presenting CD68 cells to the adjacent connective tissue are the factors inducing migration of blast leukocytic forms to the focus. Not only keratinocyte restitution capacity, but also epithelium-dependent differentiation of young leukocytes disappeared. Undifferentiated cells are migrated from the blood to the epithelium alteration zone, but not in the reverse direction. The insufficiency or the absence of blood blast cell differentiation of the in the focus of epidermal injury and adjacent tissue triggers carcinogenesis. The authors suggest their model of carcinogenesis. The conclusions offer a new concept of cancer pathogenesis and suggest a new strategy in the search for methods for early diagnosis of carcinogenesis.
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15
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Reva IV, Reva GV, Yamamoto T, Girya OY, Grakhova NV, Maloman NY, Danilenko MV. Distribution of antigen-presenting cells CD68 in papillomavirus infection in the skin. Bull Exp Biol Med 2014; 157:56-61. [PMID: 24915947 DOI: 10.1007/s10517-014-2491-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Indexed: 10/25/2022]
Abstract
We analyzed local reactions of immune homeostasis in the human skin, in particular, effector immune cells CD68 responsible for antigen presentation, during human papillomavirus infection. Under conditions of long-term papillomavirus infection, CD68 markers were identifi ed only in the connective tissue of the skin (derma) and were completely absent in the epidermis, where they were found during physiological and reparative regeneration after thermal injury. We concluded that hypertrophy of the epidermis and connective tissue of the dermal papillary layer in human papillomavirus infection is related to the absence of CD68 immune cells in the epithelial plate and their accumulation in the connective tissue adjacent to the basement membrane of the epidermis. The possibility of epithelium contamination with the virus depends on local immune homeostasis. Therefore, induction of proper CD68 distribution in appropriate structures can contribute to normalization of epithelial-connective tissue interactions.
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Affiliation(s)
- I V Reva
- School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia,
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16
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Wheless L, Jacks S, Mooneyham Potter KA, Leach BC, Cook J. Skin cancer in organ transplant recipients: more than the immune system. J Am Acad Dermatol 2014; 71:359-65. [PMID: 24725477 DOI: 10.1016/j.jaad.2014.02.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/08/2014] [Accepted: 02/11/2014] [Indexed: 02/08/2023]
Abstract
Organ transplant recipients (OTRs) are at increased risk of developing nonmelanoma skin cancers. This has long been thought to be caused by immunosuppression and viral infection. However, skin cancer risk among individuals with AIDS or iatrogenic immunodeficiency does not approach the levels seen in OTRs, suggesting other factors play a critical role in oncogenesis. In clinical trials of OTRs, switching from calcineurin inhibitors to mammalian target of rapamycin inhibitors consistently led to a significant reduction in the risk of developing new skin cancers. New evidence suggests calcineurin inhibitors interfere with p53 signaling and nucleotide excision repair. These two pathways are associated with nonmelanoma skin cancer, and squamous cell carcinoma in particular. This finding may help explain the predominance of squamous cell carcinoma over basal cell carcinoma in this population. Mammalian target of rapamycin inhibitors do not appear to impact these pathways. Immunosuppression, viral infection, and impaired DNA repair and p53 signaling all interact in OTRs to create a phenotype of extreme risk for nonmelanoma skin cancer.
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Affiliation(s)
- Lee Wheless
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina; Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Sarah Jacks
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Kathryn Anne Mooneyham Potter
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina; Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Brian C Leach
- Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
| | - Joel Cook
- Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
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17
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Bernat-García J, Morales Suárez-Varela M, Vilata-Corell J, Marquina-Vila A. Detection of Human Papillomavirus in Nonmelanoma Skin Cancer Lesions and Healthy Perilesional Skin in Kidney Transplant Recipients and Immunocompetent Patients. ACTA ACUST UNITED AC 2014; 105:286-94. [DOI: 10.1016/j.adengl.2013.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/27/2013] [Indexed: 01/20/2023]
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18
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Detección del virus del papiloma humano en muestras de cáncer cutáneo no melanoma y piel sana perilesional en pacientes trasplantados renales y pacientes inmunocompetentes. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.ad.2013.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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