Cornoid Lamella-Like Structures in HIV-Associated Epidermodysplasia Verruciformis

Abstract

Abstract:Epidermodysplasia verruciformis (EV) is an uncommon inherited skin condition with increased vulnerability to widespread infection by certain human papillomavirus types, resulting in extensive verruca plana-like papules coalescing to large confluent plaques. Since the AIDS epidemic starting in the 1980s, an acquired type of EV has been described in patients infected with human immunodeficiency virus. The histopathologic features of EV consist of papillated epidermal hyperplasia with hypergranulosis and a distinct bluish-gray color in the large human papillomavirus-infected keratinocytes in the stratum granulosum. The authors present a case of HIV-associated EV with a unique histopathologic finding of multiple cornoid lamella-like structures. To the authors' knowledge, this finding has not been previously described in the literature.

Human polyomavirus 6 and 7 are associated with pruritic and dyskeratotic dermatoses

“…This study also broadens the range of immunosuppressed states that may allow for HPyV7 infection from iatrogenic immunosuppression from organ transplantation to the immunocompromised state of HIV infection. Of note, the HIV patient described here was noted to have several types of HPV by PCR and has been diagnosed with a variant of epidermodysplasia verruciformis 13 . Although the data here suggest that HPyV7 infection contributed significantly to the patient’s disease, HPV co-infection could also contribute to the patient’s clinical and histologic findings.…”

“…We identify HPyV6 and 7 infection in three additional patients with pruritic dermatoses and provide evidence for the involvement of these viruses in the pathogenesis of the eruptions 12, 13 . Our work expands the spectrum of skin diseases associated with HPyV6 and 7 and yields novel insights into the biology of these ubiquitous skin polyomaviruses.…”

“…Importantly, all cases were first identified based on biopsies that showed a characteristic histologic pattern—scattered dyskeratotic cells throughout the epidermis along with irregular columns of parakeratosis in the stratum corneum (Fig 1B). This pattern has been described in the literature as “columnar dyskeratosis,” “tiered parakeratosis with dyskeratosis,” or “peacock plumage” 9, 12, 13 . FFPE lesional skin biopsy samples from these patients were screened for known human polyomaviruses by endpoint PCR.…”

“…The clinical characteristics of the patients, which have been previously reported, are summarized in Table I 12, 13 . All three patients presented with generalized, scaly, hyperpigmented papules coalescing into plaques, which had all been present for at least 12 months.…”

Cutaneous myxomas and a psammomatous melanotic schwannoma in a patient with Carney complex

“…14 18 though it can be found in other neoplasms including actinic and seborrheic keratoses, 19 and has recently been described as an incidental finding in lesions of epidermodysplasia verruciformis. 20 Though a hyperkeratotic element has been described overlying FIGURE 2 Histological features of cutaneous myxomas (A-D; H&E stained, ×100). Noteworthy elements include a pale-staining, hypocellular dermis containing spindle-shaped cells.…”