1
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Kilich G, Perelygina L, Sullivan KE. Rubella virus chronic inflammatory disease and other unusual viral phenotypes in inborn errors of immunity. Immunol Rev 2024; 322:113-137. [PMID: 38009321 DOI: 10.1111/imr.13290] [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] [Indexed: 11/28/2023]
Abstract
Infectious susceptibility is a component of many inborn errors of immunity. Nevertheless, antibiotic use is often used as a surrogate in history taking for infectious susceptibility, thereby disadvantaging patients who present with viral infections as their phenotype. Further complicating clinical evaluations are unusual manifestations of viral infections which may be less familiar that the typical respiratory viral infections. This review covers several unusual viral phenotypes arising in patients with inborn errors of immunity and other settings of immune compromise. In some cases, chronic infections lead to oncogenesis or tumor-like growths and the conditions and mechanisms of viral-induced oncogenesis will be described. This review covers enterovirus, rubella, measles, papillomavirus, and parvovirus B19. It does not cover EBV and hemophagocytic lymphohistiocytosis nor lymphomagenesis related to EBV. EBV susceptibility has been recently reviewed. Our goal is to increase awareness of the unusual manifestations of viral infections in patients with IEI and to describe treatment modalities utilized in this setting. Coincidentally, each of the discussed viral infections can have a cutaneous component and figures will serve as a reminder of the physical features of these viruses. Given the high morbidity and mortality, early recognition can only improve outcomes.
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Affiliation(s)
- Gonench Kilich
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ludmila Perelygina
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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2
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Mohammad Deeb A, Mohammad Deeb E, Al-Soufi L. Epidermodysplasia verruciformis arising in a female with systemic lupus erythematosus: a rare case from Syria. Ann Med Surg (Lond) 2024; 86:1101-1105. [PMID: 38333298 PMCID: PMC10849436 DOI: 10.1097/ms9.0000000000001602] [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: 09/15/2024] [Accepted: 11/29/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction and importance Epidermodysplasia verruciformis is a rare autosomal recessive genodermatosis. Clinical manifestations might be helpful in the diagnosis of this disease. However, the final diagnosis is made after a genetic and histological study. Acquired epidermodysplasia verruciformis is a form of epidermodysplasia verruciformis described in patients with compromised cell-mediated immunity. Case presentation A 42-year-old female with a history of a pain and itch on the soles and palms started a year ago. There were multiple flat papules on the dorsal hands, scarring alopecia, malar rash, oral ulcers, Raynaud phenomenon, and palpable purpura. A histological examination confirmed the diagnosis of epidermodysplasia verruciformis. Clinical discussion Epidermodysplasia verruciformis is an uncommon disease that affects the immune system. The coexistence of systemic lupus erythematosus and epidermodysplasia verruciformis is rarely reported in the medical literature. This paper reports a rare case in which these two diseases have coexisted. Conclusion This publication aims to document this rare case and highlight the ideal criteria in diagnosing and treating epidermodysplasia verruciformis.
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Affiliation(s)
| | | | - Lina Al-Soufi
- Department of Dermatology, National Hospital of Latakia, Latakia, Syria
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3
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Mehrotra P, Tirumalae R, Ballal S. Epidermodysplasia Verruciformis: A Study of Clinicopathologic Features, Biomarkers, and Associated Malignancies in Indian Patients. Am J Dermatopathol 2023; 45:608-612. [PMID: 37462151 DOI: 10.1097/dad.0000000000002491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
BACKGROUND Epidermodysplasia verruciformis (EDV) is a rare cutaneous manifestation of human papilloma virus infection, which has a potential for malignant transformation. The characteristic histologic features of EDV may not always be present and may often be overlooked. The use of a panel of novel biomarkers may aid in differentiating EDV from their clinical and pathologic mimics. MATERIAL AND METHODS We reviewed 20 cases histologically diagnosed as EDV from 2013 to 2022. Sections were reviewed for histopathologic features, and immunohistochemistry for p16 and Ki67 was performed. RESULTS There were 20 cases, ranging in age from 6 to 52 years with a male predominance. Four patients were immunosuppressed, and 4 patients had a positive family history. The most common presentation was hypopigmented papules and macules. In all the cases, epidermal keratinocytes showed dysmaturation, enlargement, and a blue-gray cytoplasm. These changes were very focal and superficial in 15 cases (75%). Associated malignancies included carcinoma in situ (1), trichilemmoma (2), and trichilemmal carcinoma (1). The trichilemmal tumors were seen in 2 siblings. p16 was expressed in the parabasal and basal layers in 7 of 17 cases (41%), in keratinocytes with and without inclusions. Ki67 was increased and localized to suprabasal and parabasal keratinocytes in 15 of 17 cases (88%). CONCLUSION Although striking and characteristic, the keratinocyte changes are often focal and superficial, requiring multiple step-sections. Association of EDV with familial trichilemmal neoplasms is a novel finding requiring further genetic testing. In cases of clinically suspected EDV with negative histopathologic findings, p16 and Ki67 seem useful as adjunct biomarkers and could serve as cost-effective alternatives to genotyping.
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Affiliation(s)
- Parul Mehrotra
- Department of Pathology, St. John's Medical College, Bangalore, Karnataka, India; and
| | - Rajalakshmi Tirumalae
- Department of Pathology, St. John's Medical College, Bangalore, Karnataka, India; and
| | - Sumedha Ballal
- Department of Dermatology, St. John's Medical College and Hospital, Bangalore, Karnataka, India
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4
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Ahuja R, Ramam M. Is It EDV? Indian Dermatol Online J 2023; 14:569-570. [PMID: 37521236 PMCID: PMC10373816 DOI: 10.4103/idoj.idoj_111_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Rhea Ahuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - M Ramam
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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5
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Alturo-Pons A, Alamon-Reig F, Sanmartín Novell V, Vilardell F, Martí RM. [Translated article] Congenital and Acquired Epidermodysplasia Verruciformis: A Series of 7 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T179-T182. [PMID: 36464007 DOI: 10.1016/j.ad.2022.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/17/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- A Alturo-Pons
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - F Alamon-Reig
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - V Sanmartín Novell
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - F Vilardell
- Servicio de Anatomía Patológica, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - R M Martí
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, Spain.
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6
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Alturo-Pons A, Alamon-Reig F, Sanmartín Novell V, Vilardell F, Martí RM. Congenital and Acquired Epidermodysplasia Verruciformis: A Series of 7 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:179-182. [PMID: 36055387 DOI: 10.1016/j.ad.2022.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/28/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Affiliation(s)
- A Alturo-Pons
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España
| | - F Alamon-Reig
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - V Sanmartín Novell
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España
| | - F Vilardell
- Servicio de Anatomía Patológica, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España
| | - R M Martí
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, Lleida, España.
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7
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Bartley BR, Huen A, Rady PL, Tyring SK, Nagarajan P, Aung PP, Curry JL, Ivan D, Torres-Cabala CA, Prieto VG, Cho WC. Eosinophilic homogeneous intracytoplasmic inclusion bodies: Unique viral cytopathic changes associated with epidermodysplasia verruciformis and human papillomavirus type 49. J Cutan Pathol 2022; 49:658-662. [PMID: 35262953 DOI: 10.1111/cup.14221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/18/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Abstract
Epidermodysplasia verruciformis (EDV) is a rare genodermatosis that predisposes affected individuals to persistent infection with certain types of human papillomavirus (HPV), particularly those that belong to the genus beta-HPV, including HPV-5 and HPV-8, which carry high oncogenic potential. There are three main HPV-related viral cytopathic changes in cutaneous verrucae in terms of intracytoplasmic inclusion bodies (ICBs), namely, granular, filamentous, and homogeneous type ICBs. To date, only HPV-4, HPV-60, and HPV-65 have been found in association with homogeneous ICBs. We report a unique case of HPV-49-associated EDV in a 41-year-old woman with common variable immunodeficiency, mycosis fungoides, and multiple cutaneous malignancies, including squamous cell carcinoma and Merkel cell carcinoma who presented with multiple pink papules and hyperpigmented macules on the left upper extremity. One of the skin lesions histopathologically revealed keratinocytic nuclear enlargement with abundant blue-gray cytoplasm, accompanied by hypergranulosis, characteristic of EDV, along with peculiar bright eosinophilic and homogeneous ICBs. To the best of our knowledge, this is the first reported case of EDV with detection of HPV-49 by genotyping, which features eosinophilic homogeneous ICBs, like those seen in the setting of HPV-4, HPV-60, or HPV-65 infection.
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Affiliation(s)
- Brooke R Bartley
- Department of Dermatology, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Auris Huen
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Peter L Rady
- Department of Dermatology, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Stephen K Tyring
- Department of Dermatology, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Phyu P Aung
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jonathan L Curry
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Doina Ivan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carlos A Torres-Cabala
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Victor G Prieto
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Woo Cheal Cho
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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8
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Mandikiyana Chirimuta LA, Ndowa FJ, Pascoe MJ. Cutaneous squamous cell carcinoma in vertically acquired HIV and epidermodysplasia verruciformis. South Afr J HIV Med 2022; 23:1368. [PMID: 35923606 PMCID: PMC9257709 DOI: 10.4102/sajhivmed.v23i1.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/15/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction Acquired epidermodysplasia verruciformis (EV) is a skin disorder that has been described in individuals with perinatally acquired HIV. Many cases have been identified in sub-Saharan Africa in keeping with the epidemiology of HIV infection compared to the rest of the world, where cases are rare. Epidermodysplasia verruciformis skin lesions may undergo malignant transformation. There are few documented cases of malignant transformation of these skin lesions. We describe a patient with an EV-like skin rash who developed cutaneous squamous cell carcinoma (SCC). Patient presentation A 25-year-old man, on antiretroviral treatment for 12 years, presented with a generalised skin rash since the age of 11 years, and a 7-month history of a persistent scalp ulcer. He had no history of trauma, radiation or other chronic conditions. Despite an undetectable HIV viral load, he had failed to immune reconstitute (CD4 42 cells/µL). Physical examination revealed a generalised hypopigmented, papular skin rash resembling verruca plana and a 3 cm × 3 cm ulcer with rolled edges on the right parietal region of the scalp. There were no palpable lymph nodes in the head and neck areas. Biopsy of the ulcer revealed moderately differentiated SCC. Management and outcome Wide local excision of the lesion was done under local anaesthesia and histological analysis confirmed completely excised moderately differentiated SCC. Further examination four weeks later revealed two, smaller, histologically similar scalp lesions which were completely excised. Conclusion Patients with acquired EV require thorough, frequent examination for skin lesions with possible malignant transformation. Early identification of malignant transformation and treatment with surgical intervention is curative.
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Affiliation(s)
- Linda A Mandikiyana Chirimuta
- Newlands Clinic, Ruedi Luethy Foundation, Harare, Zimbabwe
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Harare, Zimbabwe
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9
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Mathur M, Das G, Shah S, Jaiswal S, Maharjan S, Shrestha A. Epidermodysplasia Verruciformis in a Patient with a Renal Transplant: A Rare Case Report. EUROPEAN MEDICAL JOURNAL 2022. [DOI: 10.33590/10.33590/emj/21-00255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Mahesh Mathur
- Department of Dermatology, Venerology and Leprosy, College of Medical Sciences Hospital, Bharatpur, Nepal
| | - Gautam Das
- Department of Dermatology, Venerology and Leprosy, College of Medical Sciences Hospital, Bharatpur, Nepal
| | - Swati Shah
- Department of Dermatology, Venerology and Leprosy, College of Medical Sciences Hospital, Bharatpur, Nepal
| | - Sunil Jaiswal
- Department of Dermatology, Venerology and Leprosy, College of Medical Sciences Hospital, Bharatpur, Nepal
| | - Srijana Maharjan
- Department of Dermatology, Venerology and Leprosy, College of Medical Sciences Hospital, Bharatpur, Nepal
| | - Ayasha Shrestha
- Department of Community Medicine, College of Medical Sciences, Bharatpur, Nepal
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10
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Singhal RR, Sheth NK, Nair PA. Epidermodysplasia verruciformis with plane warts over lower abdomen and genitals. Indian J Sex Transm Dis AIDS 2020; 41:105-107. [PMID: 33062994 PMCID: PMC7529176 DOI: 10.4103/ijstd.ijstd_110_16] [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: 12/22/2016] [Revised: 12/22/2019] [Accepted: 02/25/2020] [Indexed: 11/16/2022] Open
Abstract
Epidermodysplasia verruciformis (EDV) may clinically vary from pityriasis versicolor-like macules to wart-like flat papules, psoriasiform red papules, or pigmented keratotic lesions resembling seborrheic keratosis. Sun-exposed areas are commonly affected with genital areas rarely involved. It is associated with more than 30 human papillomaviruses (HPVs). In 90% cases of squamous cell carcinomas, HPV5 and HPV8 is isolated. A case of EDV with plane warts involving the genital area in a 35-year-old male is reported here.
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Affiliation(s)
- Rochit Rajesh Singhal
- Department of Dermatology and Venereology, Pramukshwami Medical College, Karamsad, Gujarat, India
| | - Niral Ketan Sheth
- Department of Dermatology and Venereology, Pramukshwami Medical College, Karamsad, Gujarat, India
| | - Pragya Ashok Nair
- Department of Dermatology and Venereology, Pramukshwami Medical College, Karamsad, Gujarat, India
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11
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Alshammari R, Al-Issa A, Ghobara YA. Epidermodysplasia Verruciformis: A Rare Case Report. Cureus 2020; 12:e9046. [PMID: 32782865 PMCID: PMC7410503 DOI: 10.7759/cureus.9046] [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] [Indexed: 01/19/2023] Open
Abstract
Epidermodysplasia verruciformis (EV) is an uncommon disorder that is transmitted in an autosomal recessive manner. It is characterized by increased susceptibility to human papillomavirus (HPV) infection, which presents with hypo- or hyperpigmented macular lesions, pityriasis versicolor-like lesions, and an early tendency to transform into skin cancer. We present a case of a 36-year-old female with complaints of asymptomatic, multiform lesions over the face, neck, chest, and upper arms. Histopathology was suggestive of EV, and our patient was given oral isotretinoin 20 mg/day and advised strict photoprotection.
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Affiliation(s)
- Rasha Alshammari
- Medicine and Surgery, University of Hail, College of Medicine, Hail, SAU
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12
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da Cruz Silva LL, de Oliveira WRP, Pereira NV, Halpern I, Tanabe CKFD, Mattos MSG, Sotto MN. Claudin expression profile in flat wart and cutaneous squamous cell carcinoma in epidermodysplasia verruciformis. Sci Rep 2020; 10:9268. [PMID: 32518268 PMCID: PMC7283482 DOI: 10.1038/s41598-020-66065-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/07/2020] [Indexed: 11/09/2022] Open
Abstract
Epidermodysplasia verruciformis (EV) is a genodermatosis related to human beta-papillomavirus (beta-HPV), with a high risk of cutaneous squamous cell carcinoma (cSCC). Claudins are transmembrane proteins expressed in epithelia and may be altered during carcinogenesis. For a better understanding of the role of beta-HPV in cutaneous carcinogenesis, this claudin expression study was conducted on lesions of patients with and without EV. In this study, claudins-1, -2, -3, -4, -5, -7 and -11 expressions were analyzed by applying the immunohistochemistry technique, in samples of 108 normal skin, 39 flat warts and 174 cSCC. The cSCC samples were organized in tissue microarrays. We found that claudin-1 and claudin-3 focal expressions were associated with cSCC (p < 0.001), and claudin-2 focal or negative expression with flat wart (p < 0.001), in EV and NEV (non-EV) groups. For claudin-5, EV group showed a lower chance of focal and negative expression (p < 0.001), and its negative expression was associated with flat wart (p < 0.001) and lower mean age (p < 0.001). Claudins-4, -7 and -11 showed a diffuse expression in almost all studied samples. Our findings suggest that claudin-5 increased expression observed on normal skin, flat wart and cSCC showed association with EV. Claudin-1 and -3 down expression were also observed, but they could not be related to beta-HPV infection.
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Affiliation(s)
- Lana Luiza da Cruz Silva
- Departament of Dermatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | - Naiura Vieira Pereira
- Departament of Dermatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ilana Halpern
- Departament of Dermatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Mirian N Sotto
- Departament of Dermatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.,Departament of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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13
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da Cruz Silva LL, de Oliveira WRP, Sotto MN. Epidermodysplasia verruciformis: revision of a model of carcinogenic disease. SURGICAL AND EXPERIMENTAL PATHOLOGY 2019. [DOI: 10.1186/s42047-019-0046-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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14
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Uddin KMF, Amin R, Majumder SN, Aleem MA, Rahaman A, Dity NJ, Baqui MDA, Akter H, Rahman MM, Woodbury‐Smith M, Scherer S, Uddin M. An ANKRD26 nonsense somatic mutation in a female with epidermodysplasia verruciformis (Tree Man Syndrome). Clin Case Rep 2018; 6:1426-1430. [PMID: 30147876 PMCID: PMC6099040 DOI: 10.1002/ccr3.1595] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/22/2018] [Accepted: 04/26/2018] [Indexed: 12/13/2022] Open
Abstract
Epidermodysplasia verruciformis (EV) is an extremely rare hereditary skin disease characterized by an abnormal susceptibility to the human papilloma virus (HPV) with an increased risk of cutaneous malignancy. Here we report the first female severe EV case in Bangladesh, a 10-year-old girl with a nonsense somatic mutation impacting ANKRD26 gene.
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Affiliation(s)
- K. M. Furkan Uddin
- Holy Family Red Crescent Medical CollegeDhakaBangladesh
- NeuroGen Technologies Ltd.DhakaBangladesh
| | - Robed Amin
- Department of MedicineDhaka Medical CollegeDhakaBangladesh
| | | | - Mohammad Abdul Aleem
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B)DhakaBangladesh
| | | | | | - M. D. Abdul Baqui
- Holy Family Red Crescent Medical CollegeDhakaBangladesh
- NeuroGen Technologies Ltd.DhakaBangladesh
| | | | | | - Marc Woodbury‐Smith
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK
- The Centre for Applied GenomicsThe Hospital for Sick ChildrenTorontoONCanada
| | - Stephen Scherer
- The Centre for Applied GenomicsThe Hospital for Sick ChildrenTorontoONCanada
- Program in Genetics and Genome Biology (GGB)The Hospital for Sick ChildrenTorontoONCanada
- Department of Molecular GeneticsUniversity of TorontoTorontoONCanada
- McLaughlin CentreUniversity of TorontoTorontoONCanada
| | - Mohammed Uddin
- The Centre for Applied GenomicsThe Hospital for Sick ChildrenTorontoONCanada
- College of MedicineMohammed Bin Rashid University of Medicine and Health SciencesDubaiUAE
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15
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Liu YQ, Zhang GL, Mo XH, Wang B, Wu F, Chen J, Luo H, Zhu LD, Xu MY, Zhou Q, Cai QL, Wang XL. A novel homozygous DOCK8 mutation associated with unusual coexistence of gross molluscum contagiosum and epidermodysplasia verruciformis in a DOCK8 deficiency patient. J Eur Acad Dermatol Venereol 2017; 31:e504-e505. [PMID: 28670845 DOI: 10.1111/jdv.14344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y-Q Liu
- Department of Pathology, Central Laboratory, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - G-L Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - X-H Mo
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Key Laboratory of Medical Molecular Virology (Ministries of Education and Health), Department of Etiology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - B Wang
- Department of Dermatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - F Wu
- Department of Pathology, Central Laboratory, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - J Chen
- Department of Pathology, Central Laboratory, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - H Luo
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - L-D Zhu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - M-Y Xu
- Department of Pathology, Central Laboratory, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Q Zhou
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Q-L Cai
- Key Laboratory of Medical Molecular Virology (Ministries of Education and Health), Department of Etiology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - X-L Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
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16
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17
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Comparative study of p16 protein expression in squamous cell carcinomas from patients with epidermodysplasia verruciformis and patients without the disease. Arch Dermatol Res 2017; 309:479-483. [DOI: 10.1007/s00403-017-1742-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/24/2017] [Accepted: 04/18/2017] [Indexed: 11/27/2022]
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18
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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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Li SL, Duo LN, Wang HJ, Dai W, Zhou EYH, Xu YN, Zhao T, Xiao YY, Xia L, Yang ZH, Zheng LT, Hu YY, Lin ZM, Wang HN, Gao TW, Ma CL, Yang Y, Li CY. Identification of LCK mutation in a family with atypical epidermodysplasia verruciformis with T-cell defects and virus-induced squamous cell carcinoma. Br J Dermatol 2016; 175:1204-1209. [PMID: 27087313 DOI: 10.1111/bjd.14679] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Inherited epidermodysplasia verruciformis (EV) is a rare skin disorder characterized by susceptibility to specific types of human papilloma virus (HPV) and is strongly associated with skin carcinomas. Inactivating mutations in EVER1/EVER2 account for most cases of EV. However, more phenotypes related to but distinct from EV have been reported with an immunodeficiency state but without EVER1/EVER2 mutation, and the genetic basis for these atypical EV cases is poorly understood. OBJECTIVES To identify the causative gene responsible for three siblings affected by atypical EV but without EVER1/EVER2 mutation. METHODS Whole-exome sequencing followed by Sanger sequencing was performed to identify the gene responsible for the patients with atypical EV enrolled in our study. RESULTS A homozygous splicing mutation was detected in LCK (c.188-2A>G). This mutation resulted in an exon 3 deletion T lymphocyte-specific protein tyrosine kinase isoform, which further led to frameshift mutation and subsequent mRNA decay. CONCLUSIONS We demonstrate a novel mutation in LCK in a family affected by atypical EV with T-cell defects, HPV infection and virus-induced malignancy, providing new clues in the understanding of host defences against HPV and better genetic counselling of patients with the EV phenotype.
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Affiliation(s)
- S-L Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L-N Duo
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China.,Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - H-J Wang
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China.,Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - W Dai
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - E-Y H Zhou
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Y-N Xu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - T Zhao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Y-Y Xiao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L Xia
- Department of Dermatology, General Hospital of Ningxia Medical University, Yinchuan, Ning Xia, China
| | - Z-H Yang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, Ning Xia, China
| | - L-T Zheng
- Novogene Bioinformatics Technology Co., Ltd, Beijing, China
| | - Y-Y Hu
- Novogene Bioinformatics Technology Co., Ltd, Beijing, China
| | - Z-M Lin
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - H-N Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - T-W Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - C-L Ma
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Y Yang
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
| | - C-Y Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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Morales-Sánchez MA, Peralta-Pedrero ML, Jurado-Santa Cruz F, Pomerantz H, Barajas-Nava LA. Interventions for preventing keratinocyte cancer in high-risk groups not receiving immunosuppressive therapy. Hippokratia 2016. [DOI: 10.1002/14651858.cd012266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Martha Alejandra Morales-Sánchez
- Dermatological Center, "Dr. Ladislao de la Pascua"; Education and Research Unit; Dr. José María Vértiz No. 464 Col. Buenos Aires México City Mexico 06780
| | - María Luisa Peralta-Pedrero
- Dermatological Center, "Dr. Ladislao de la Pascua"; Education and Research Unit; Dr. José María Vértiz No. 464 Col. Buenos Aires México City Mexico 06780
| | - Fermín Jurado-Santa Cruz
- Dermatological Center, "Dr. Ladislao de la Pascua"; Education and Research Unit; Dr. José María Vértiz No. 464 Col. Buenos Aires México City Mexico 06780
| | - Hyemin Pomerantz
- Hofstra Northwell School of Medicine; Department of Dermatology; Hempstead New York USA
| | - Leticia A Barajas-Nava
- Hospital Infantil de México Federico Gómez (HIMFG), Health National Institute; Evidence-Based Medicine Research Unit; Dr. Márquez #162 Col. Doctores, Del. Cuauhtémoc México City Mexico 06720
- Iberoamerican Cochrane Network; Institute of Biomedical Research (IIB Sant Pau), C/ Sant Antoni Ma Claret 171 Casa de Convalescència Barcelona Barcelona Spain 08041
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Lau C, Acharya S, Arumainayagam JT, Kasparis C, Dhesi I. Acquired epidermodysplasia verruciformis in an HIV-positive patient. Int J STD AIDS 2015; 27:1023-5. [PMID: 26516132 DOI: 10.1177/0956462415613933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/02/2015] [Indexed: 11/16/2022]
Abstract
Epidermodysplasia verruciformis (EV) is a rare dermatological manifestation of the human papillomavirus (HPV) infection, which causes distinctive skin lesions in sun-exposed areas. Both inherited and acquired forms exist. Immunocompromised individuals, such as HIV patients, are at risk of acquired EV. EV poses challenges in its management and variable responses are seen in different individuals. In addition, EV carries a significant risk of skin malignancy with certain HPV types that require skin surveillance. A case of acquired EV in a HIV-positive patient is presented in this report.
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Affiliation(s)
- Carmen Lau
- Department of HIV and Genitourinary Medicine, Walsall Manor Hospital, UK
| | - Sashi Acharya
- Department of HIV and Genitourinary Medicine, Walsall Manor Hospital, UK
| | | | | | - I Dhesi
- Department of Histopathology, Walsall Manor Hospital, UK
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22
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de Oliveira WR, da Cruz Silva LL, Neto CF, Tyring S. Deleterious Effect of Radiation Therapy on Epidermodysplasia Verruciformis Patients. J Cutan Med Surg 2015; 19:416-21. [PMID: 26156649 DOI: 10.1177/1203475415576859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Epidermodysplasia verruciformis (EV) is a rare genodermatosis caused by specific human papillomavirus (HPV) types associated with the development of multiple squamous cell carcinomas (SCC). The treatment for this skin tumour may be difficult. Among the therapy options, radiotherapy (RT) should be avoided due to its deleterious effects on HPV-induced carcinogenesis. OBJECTIVE To describe 4 patients with EV who underwent radiotherapy to treat cutaneous SCC. METHODS This is a retrospective study. The evolution of cutaneous SCC after adjuvant radiotherapy in 4 patients with EV was observed. RESULTS This study included 4 patients with diagnosis of EV. All 4 of the patients had cutaneous SCC. They underwent surgical resection and adjuvant radiotherapy. Over a period of up to 2 years, there was aggressive tumour recurrence. CONCLUSION Radiotherapy might be associated with progression of SCC in patients with EV, and it is recommended that radiotherapy should be avoided in this patient population.
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Affiliation(s)
| | | | | | - Stephen Tyring
- The University of Texas Health Science Center, Houston, TX, USA
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23
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Ding X, Lucas T, Marcuzzi GP, Pfister H, Eming SA. Distinct Functions of Epidermal and Myeloid-Derived VEGF-A in Skin Tumorigenesis Mediated by HPV8. Cancer Res 2014; 75:330-43. [DOI: 10.1158/0008-5472.can-13-3007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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24
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Landini MM, Borgogna C, Peretti A, Colombo E, Zavattaro E, Boldorini R, Miglio U, Doorbar J, Ravanini P, Kumar R, Moratto D, Badolato R, De Andrea M, Gariglio M. α- and β-Papillomavirus infection in a young patient with an unclassified primary T-cell immunodeficiency and multiple mucosal and cutaneous lesions. J Am Acad Dermatol 2014; 71:108-15.e1. [DOI: 10.1016/j.jaad.2014.01.859] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/27/2013] [Accepted: 01/08/2014] [Indexed: 12/30/2022]
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25
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Holloway A, Storey A. A conserved C-terminal sequence of high-risk cutaneous beta-human papillomavirus E6 proteins alters localization and signalling of β1-integrin to promote cell migration. J Gen Virol 2013; 95:123-134. [PMID: 24154967 DOI: 10.1099/vir.0.057695-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Beta-human papillomaviruses (β-HPV) infect cutaneous epithelia, and accumulating evidence suggests that the virus may act as a co-factor with UV-induced DNA damage in the development and progression of non-melanoma skin cancer, although the molecular mechanisms involved are poorly understood. The E6 protein of cutaneous β-HPV types encodes functions consistent with a role in tumorigenesis, and E6 expression can result in papilloma formation in transgenic animals. The E6 proteins of high-risk α-HPV types, which are associated with the development of anogenital cancers, have a conserved 4 aa motif at their extreme C terminus that binds to specific PDZ domain-containing proteins to promote cell invasion. Likewise, the high-risk β-HPVs HPV5 and HPV8 E6 proteins also share a conserved C-terminal motif, but this is markedly different from that of α-HPV types, implying functional differences. Using binding and functional studies, we have shown that β-HPV E6 proteins target β1-integrin using this C-terminal motif. E6 expression reduced membrane localization of β1-integrin, but increased overall levels of β1-integrin protein and its downstream effector focal adhesion kinase in human keratinocytes. Altered β1-integrin localization due to E6 expression was associated with actin cytoskeleton rearrangement and increased cell migration that was abolished by point mutations in the C-terminal motif of E6. We concluded that modulation of β1-integrin signalling by E6 proteins may contribute towards the pathogenicity of these β-HPV types.
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Affiliation(s)
- Amy Holloway
- Department of Oncology, University of Oxford, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DS, UK
| | - Alan Storey
- Department of Oncology, University of Oxford, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DS, UK
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26
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Lowe SM, Katsidzira L, Meys R, Sterling JC, de Koning M, Quint W, Nathoo K, Munyati S, Ndhlovu CE, Salisbury JR, Bunker CB, Corbett EL, Miller RF, Ferrand RA. Acquired epidermodysplasia verruciformis due to multiple and unusual HPV infection among vertically-infected, HIV-positive adolescents in Zimbabwe. Clin Infect Dis 2012; 54:e119-23. [PMID: 22474219 PMCID: PMC3334361 DOI: 10.1093/cid/cis118] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We have previously described the presentation of epidermodysplasia verruciformis (EV)-like eruptions in almost a quarter of hospitalized adolescents with vertically-acquired human immunodeficiency virus (HIV) infection in Harare, Zimbabwe, a region with a high prevalence of HIV infection. METHODS We performed a clinical case note review and skin biopsy from affected sites in 4 HIV-infected adolescents with EV-like lesions in Harare. Biopsies were processed for histology and for human papillomavirus (HPV) typing. RESULTS All patients had long-standing skin lesions that pre-dated the diagnosis of HIV by several years. The histology of skin biopsies from all patients was consistent with EV. In each biopsy, EV-associated β-HPV type 5 was identified (additionally, type 19 was found in 1 biopsy). Cutaneous wart-associated HPV types 1 and 2 were detected in all biopsies, together with genital lesion-associated HPV types 6, 16, and 52, (as well as ≥3 other genital lesion-associated HPV types). Despite immune reconstitution with combination antiretroviral therapy (cART), there was no improvement in EV-like lesions in any patient. CONCLUSIONS EV is a disfiguring and potentially stigmatizing condition among this patient group and is difficult to treat; cART appears to have no impact on the progression of skin disease. Among adolescents with longstanding HIV-induced immunosuppression and with high levels of sun exposure, close dermatological surveillance for potential skin malignancy is required.
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Affiliation(s)
- S M Lowe
- Biomedical Research and Training Institute, University of Zimbabwe, Harare, Zimbabwe.
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Hayashi S, Hatamochi A, Soutome A, Hamasaki Y, Yamazaki S, Kawase M, Tadano M, Kitasato H. A case of epidermodysplasia verruciformis (EV) with human papillomavirus 16 (HPV16) DNA detected in the skin lesions: can HPV16 infect patients with EV? Int J Dermatol 2011; 50:1168-70. [DOI: 10.1111/j.1365-4632.2009.04451.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Sá NBD, Guerini MB, Barbato MT, Giunta GD, Nunes DH. Epidermodisplasia verruciforme: apresentação clínica com variadas formas de lesões. An Bras Dermatol 2011; 86:S57-60. [DOI: 10.1590/s0365-05962011000700014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 12/14/2010] [Indexed: 05/26/2023] Open
Abstract
Epidermodisplasia verruciforme é uma genodermatose rara caracterizada por infecção disseminada por HPV, de caráter recessivo, com casos ligados ao cromossoma X. É caracterizada clinicamente por lesões maculares hipo ou hiperpigmentadas, lesões pitiríase versicolor like, verrugas planas e desenvolvimento precoce de carcinomas cutâneos. Descreve-se um caso de paciente com quadro clínico exuberante, apresentando todas as formas de lesões desta doença, inclusive presença de carcinoma espinocelular agressivo na face
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29
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Ribas J, Corrêa CDA, Cavalcante MDSM. Case for diagnosis. An Bras Dermatol 2011; 86:391. [PMID: 21603836 DOI: 10.1590/s0365-05962011000200035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Indexed: 11/22/2022] Open
Abstract
A 27-year-old mixed-raced (pardo) female patient presented with flat ovate hypochromic plaques with a rough surface on the back and upper limbs, with an aspect resembling pityriasis versicolor. She reports family history involving a brother with similar lesions. Lab tests, including anti-HIV, showed no alterations and a histopathological examination showed enlarged keratinocytes with basophilic and microvacuolated cytoplasm occupying the upper portion of the spinous layer and the granulous layer. After anatomic-clinical correlation, the diagnosis of epidermodysplasia verruciformis pityriasis versicolor like was confirmed.
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Affiliation(s)
- Jonas Ribas
- Federal University of Amazonas (UFAM) – Manaus (AM), Brazil.
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30
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Mertz K, Schmid M, Burger B, Itin P, Palmedo G, Schärer L, Kutzner H, Fernández Figueras M, Cribier B, Pfaltz M, Kempf W. Detection of Merkel Cell Polyomavirus in Epidermodysplasia-Verruciformis-Associated Skin Neoplasms. Dermatology 2010; 222:87-92. [DOI: 10.1159/000321880] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 09/30/2010] [Indexed: 11/19/2022] Open
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Abstract
BACKGROUND Epidermodysplasia verruciformis (EV) is a genodermatosis, characterized by human papilloma virus infection, with polymorphic and disseminated lesions that develop malignant transformation in approximately half of patients. MATERIALS AND METHODS We describe clinical and epidemiological features of 10 cases of EV during a 5-year period. All were treated using curettage of the nonmalignant wart-like lesions with a curette and application of 35% trichloroacetic acid (TCA) with a cotton bud for a few seconds. RESULTS Ten patients aged 33 to 67, nine women and one man, were treated, mainly presenting flat, brownish, wart-like lesions distributed on the anterior and posterior trunk. Two patients developed squamous cell carcinoma, histologically confirmed, that was surgically removed using fusiform excision. Good cosmetic results were obtained, and there was no reappearance of lesions during a mean follow-up of 3.5 years. CONCLUSION Curettage and application of 35% TCA that we have used in these patients has been shown to be an effective and low-cost alternative, compared to oral, topical, or other physical ablative therapies, with satisfactory cosmetic results and no recurrence during follow-up.
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Affiliation(s)
- Mariana V Hoffner
- Department of Dermatology, Virgen Macarena University Hospital, Seville, Spain.
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Ferreira da Silva LC, Espinosa Miranda A, de Lima Ferreira LC, Moreira da Silva R, Távora Mira M, Talhari C, Talhari S. Post-ART Epidermodysplasia Verruciformis in a Patient With AIDS. ACTA ACUST UNITED AC 2010; 9:10-4. [DOI: 10.1177/1545109709355709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Epidermodysplasia verruciformis (EV) is a rare disorder characterized by persistent human papillomavirus (HPV) infection. Here, we describe a 48-year-old, black, married male with AIDS, presenting a 1-year history of asymptomatic hypopigmented lesions that appeared 3 years after antiretroviral therapy (ART) initiation. Pre-ART, the initial CD4 count was 32 cells/mm3 and the skin lesions appeared when the CD4 count reached 122 cells/mm3. Dermatological examination demonstrated thin, scaly, slightly verrucous hypopigmented macules and papules, isolated or presenting with a linear aspect (Köbner phenomenon) in some areas, distributed on the neck, trunk, and superior and inferior members. Skin biopsy of a macular lesion revealed epidermal acanthosis with vacuolated keratinocytes presenting blue-gray pallor, arranged in clusters at the granular and upper spinous layer. Immunohistochemistry revealed expression of p16 INK4a with diffuse positivity in the upper third of the epithelium, corresponding to the vacuolated keratinocytes. Polymerase chain reaction (PCR) was positive for type 12 HPV, and a diagnosis of EV-like associated to AIDS was made. EV-like is a rare disease and in this patent might be a manifestation of immune reconstitution inflammatory syndrome.
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Affiliation(s)
- Leila Cristina Ferreira da Silva
- Enfermeira do Serviço de Assistência Especializada em DST/AIDS, Gerência de Dermatologia e DST/AIDS, Fundação de Medicina Tropical do Amazonas (FMTAM), Amazonas, Brazil
| | | | | | | | - Marcelo Távora Mira
- Centro de Ciências da Saúde e Biológicas, Universidade Pontifícia Católica. Amazonas, Brazil
| | - Carolina Talhari
- Serviço de Assistência Especializada em DST/AIDS, Gerência de Dermatologia e DST/AIDS, FMTAM, Amazonas, Brazil
| | - Sinésio Talhari
- Serviço de Assistência Especializada em DST/AIDS, Gerência de Dermatologia e DST/AIDS, FMTAM, Amazonas, Brazil,
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Boybeyi O, Akçören Z, Oğuz B, Akyüz C, Sanal O, Ergin S, Ersoy-Evans S, Tanyel FC. Multifocal leiomyosarcomatosis in a 6-year-old child with epidermodysplasia verruciformis and immune defect. J Pediatr Surg 2009; 44:e5-8. [PMID: 19573649 DOI: 10.1016/j.jpedsurg.2009.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Revised: 04/02/2009] [Accepted: 04/04/2009] [Indexed: 11/18/2022]
Abstract
Leiomyosarcoma and epidermodysplasia verruciformis are rarely encountered in children. The association of either leiomyosarcoma or epidermodysplasia verruciformis with immune deficiency has previously been documented. A 6-year-old girl, who has had multifocal leiomyosarcomatosis after the previous diagnoses of epidermodysplasia verruciformis and immune defect, represents an interesting association of these features.
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Affiliation(s)
- Ozlem Boybeyi
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey
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Karagöz B, Erikçi AA, Karabudak Ö, Bilgi O, Sayan Ö, Küçükkodacı Z, Türken O, Kandemir EG, Öztürk A. The Diagnosis of Non Hodgkin Lymphoma in an Epidermodysplasia Verruciformis Patient. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2009. [DOI: 10.29333/ejgm/82655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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35
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Joh J, Hopper K, Van Doorslaer K, Sundberg JP, Jenson AB, Ghim SJ. Macaca fascicularis papillomavirus type 1: a non-human primate betapapillomavirus causing rapidly progressive hand and foot papillomatosis. J Gen Virol 2009; 90:987-994. [DOI: 10.1099/vir.0.006544-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Papillomaviruses (PVs) are a group of small, non-enveloped DNA viruses that cause mucosal or cutaneous neoplasia in a variety of animals. Whilst most papillomas will regress spontaneously, some may persist or undergo malignant transformation. In this study, aggressive, persistent and extensive warts were observed on the hands and feet of a cynomolgus macaque (Macaca fascicularis). The presence of PV in the wart biopsies was identified by immunohistochemistry and PCR amplification of PV DNA. The genomic DNA of this PV was cloned and sequenced, and the PV was designated M. fascicularis papillomavirus type 1 (MfPV-1). Its genome was 7588 bp in length and the organization of its putative open reading frames (E1, E2, E6, E7, L1, L2 and E4) was similar to that of other PVs. MfPV-1 had a short non-coding region (NCR) of 412 bp. Molecular analysis of MfPV-1 genomic DNA classified it into the genus Betapapillomavirus, to which all epidermodysplasia verruciformis (EV)-type PVs belong. Diseases caused by PVs of the genus Betapapillomavirus are usually associated with natural or iatrogenic immunosuppression. The genomic characterization performed in this study showed that MfPV-1 clustered within the genus Betapapillomavirus and also contained EV-type-specific motifs in its NCR. Further characterization of this virus and its host interactions may allow us to develop a non-human primate model for human betapapillomaviruses, a genus populated by human PV types causing EV.
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Affiliation(s)
- Joongho Joh
- The James Graham Brown Cancer Center, The University of Louisville, Louisville, KY 40202, USA
| | - Kelly Hopper
- The Mannheimer Foundation, Homestead, FL 33034-4102, USA
| | - Koenraad Van Doorslaer
- The Albert Einstein College of Medicine and The Albert Einstein Cancer Center, Bronx, NY 10461, USA
| | - John P. Sundberg
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609-1500, USA
| | - Alfred B. Jenson
- The James Graham Brown Cancer Center, The University of Louisville, Louisville, KY 40202, USA
| | - Shin-Je Ghim
- The James Graham Brown Cancer Center, The University of Louisville, Louisville, KY 40202, USA
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36
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High beta-HPV DNA loads and strong seroreactivity are present in epidermodysplasia verruciformis. J Invest Dermatol 2008; 129:1026-34. [PMID: 18923444 DOI: 10.1038/jid.2008.317] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Epidermodysplasia verruciformis (EV) is a rare disease, characterized by cutaneous warts and associated with a strong predisposition to beta-genus human papillomavirus (HPV). Earlier studies reported high copy numbers of HPV-DNA in nearly all skin tumors from EV patients, but neither HPV replication status in non-lesional skin nor anti-HPV seroreactivity in these patients have been reported yet. We therefore performed a comprehensive viral load analysis for the more common beta-HPV types on skin samples and plucked eyebrow hairs from four EV patients treated at our dermatology department. The results clearly demonstrate that they carry a multiplicity (up to eighteen types) of beta-HPV genotypes in both skin sites. Worthy of note, a high intrapatient concordance for specific types between hair bulbs and skin biopsies was observed and the same beta-PV profile was maintained over time. Viral load analysis revealed a load range between less than one HPV-DNA copy per 100 cells to more than 400 HPV-DNA copies per cell in both eyebrow hairs and skin proliferative lesions. Evaluation of seroreactivity to beta-HPV types in the four EV patients revealed that antibodies against the 16 beta-HPV were significantly more prevalent and showed higher titers than in the controls.
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