Detection of human papillomaviruses and eccrine ducts in palmoplantar epidermoid cysts

Abstract

Summary Although epidermoid cysts of the palms and soles have long been assumed to develop following implantation of an epidermal fragment as a result of a penetrating injury, the pathogenic mechanism is still controversial, and the discovery of a more common aetiological agent is awaited. Clinical, histological, immunohistochemical and molecular biological studies were performed on 119 epidermoid cysts of palmoplatitur location, in order to examine the rote of the eccrine ducts, and human papillomavirus (HPV), in the pathogenesis of this disorder. Characteristic histological features were found, including intracytoplasmic eosinophilic bodies (ICB: in 14 cases. 12%) in the cyst wall, vacuolar structures (V: in 28 cases, 24%), or parakeratotic nuclei (P: in 85 cases. 71%) within the keratinous mass in the cyst cavity. Ductal structures suggesting eccrine ducts (E: in 63 cases, 53%) were also found in the cyst wall or in the cyst cavity. Hither ductal structures or carcinoembryonic antigen expression (66 cases, 55%) were noted in a total of 73 cases (61%). Papillomavirus common antigens were detected in 36 cases (30%) showing one or more of the three distinct histological features, i.e. ICB, V and P, Subsequently, hybridization experiments to detect HPV DNA were performed in 47 cases, revealing an association between cysts showing ICB or V and the presence of HPV 60 DNA sequences. On the basis of our results, we propose that epidermoid cysts in the palmoplantar regions may develop from eccrine ducts, and that HPV and injury may play a role in their pathogenesis.

Human papillomavirus infection and ultraviolet light exposure as epidermoid inclusion cyst risk factors in a patient with epidermodysplasia verruciformis?

“…Epidermodysplasia verruciformis (EV) is a rare disease characterized by extensive symptomatic cutaneous infection with specific human papillomavirus (HPV) genotypes including HPV 5,8,9,12,14,15,17,[19][20][21][22][23][24][25]46, 47, 50. 1 Two susceptibility loci for EV have been identified, EV1 on chromosome 17q, and EV2 on chromosome 2p.…”

Multiple palmar epidermoid cysts: fourth reported case

“…In the present case, cyst wall did not reveal any histological changes suggestive of HPV infection such as vacuolated structures and intracytoplasmic eosinophilic inclusions. [5][6][7][8][9] In addition, HPV infection was not detected in the cyst wall cells in situ hybridization and PCR examinations. HPV DNA fragments were amplified by Polymerase Chain Reaction (PCR) examinations performed by the method described by Saiki et al 12 using a thermal cycler (Perkin Elmer PJ 2000) and degenerate primers developed by Shamanin et al 13 Therefore, HPV did not contribute to the development of epidermoid cysts in our case.…”

“…Egawa et al 1,9 speculated that HPV-60 had a high affinity to eccrine duct epithelia and played a role in the cyst formation, since HPV-60 was concomitantly demonstrated with eccrine duct origin in plantar epidermoid cysts. In the present case, cyst wall did not reveal any histological changes suggestive of HPV infection such as vacuolated structures and intracytoplasmic eosinophilic inclusions.…”

“…4 However, it is improbable that palmoplantar epidermoid cysts develop from pilosebaceous structures. On the other hand, recent investigations indicate that palmoplantar epidermoid cysts are caused by human papillomavirus (HPV) infection [5][6][7][8][9][10] and that they develop from eccrine ducts.…”

Verrucous Cyst With Melanocytic and Sebaceous Differentiation: A Case Report and Review of the Literature

“…In particular, HPV-60 has been associated with the specific type of verrucous cyst found predominantly on the plantar surface of the feet. 3 Verrucous cysts located elsewhere on the body typically are not connected to the epidermal surface and have been associated with HPV types 20, 34, 8, and 6. 4,5 The presence of the HPV virus has traditionally been demonstrated with molecular methods and IHC staining for HPV antigens 1,2,6 ; however, our case represents the first reported instance, to our knowledge, demonstrating the presence of HPV with p16 positivity in a verrucous cyst.…”