Heterogeneity of human papillomavirus DNA in a patient with Bowenoid papulosis that progressed to squamous cell carcinoma

Abstract

Bowenoid papulosis (BP) of the genitalia, characterized by the histological findings of a squamous cell carcinoma, follows a largely benign clinical course. The detection of oncogenic human papilloma viruses (HPV) from BP points to an aetiological role of these viral infections. A 47-year-old man with multiple genital skin lesions was seen over a 10-year period with the diagnosis of BP. Recently, he attended again with a recurrent genital tumour that was diagnosed as squamous cell carcinoma. His genital lesions progressed and became polymorphic in appearance, from a wart-like tumour to a reddish invasive plaque. To screen for the presence of different HPV sequences from different skin lesions and to correlate each HPV type with distinct clinical manifestations, polymerase chain reaction and single-strand conformational polymorphism (PCR-SSCP) were performed. PCR-SSCP revealed the presence of several types of HPV from different genital lesions. Sequencing results disclosed that he had a mixed infection of HPV6b, HPV16, HPV18 and HPV33, respectively. Interestingly, the clinical findings were fairly well correlated with the oncogenic potential of HPV found from each lesion.

Human Papillomavirus-32-Positive Extragenital Bowenoid Papulosis (BP) in a HIV Patient With Typical Genital BP Localization

“…Moreover, DNA integration had been never investigated before, not even in the BP cases of the genitalia that developed squamous cell carcinoma. 10,11 The interest of this case is also the presence of 2 different HPV types in histologically very similar lesions, in different sites in the same person, with no cross-contamination. The 2 genotypes have completely different characteristics: type 16 is the high-risk HPV more commonly found in cervical carcinomas, whereas HPV type 32 is the causative agent of a benign disease of the oral cavity termed focal epithelial hyperplasia (FEH) or Heck's disease.…”

Role of human papillomavirus in penile cancer, penile intraepithelial squamous cell neoplasias and in genital warts

“…PIN 3 in a young male may spontaneously regress, as do VIN 3 lesions in young female patients [56]. The lesions may also recur and become malignant [59]. This, however, is a rare event, seen particularly in severely immunodeficient patients such as HIV-positive individuals and transplant recipients [24].…”

“…1), whereas they are only rarely detected in high-grade dysplasia or invasive cancers [42]. In contrast, high-risk HPV-types (HPV 16,18,31,33,35,39,45,51,52,54,56,58,59,66,68,69) are regularly associated with high-grade dysplasias, in situ carcinoma or invasive carcinomas of the cervix uteri, of the vagina and the anus, but also of the external genitalia of both sexes: such as penile intraepithelial neoplasia (PIN) and vulvar intraepithelial neoplasia (VIN) [3,4,6,22,29,31,32,36,56].…”

Human papillomavirus–related genital disease in the immunocompromised host

“…1,2 Smoking has also been linked to an increased risk of anogenital warts. 3,4 Cigarette smoking has been strongly linked to the risk of anogenital warts in men, with a dose-dependent response in which smokers of more than 10 cigarettes per day have been shown to be twice as likely to have anogenital warts as nonsmoking men. 5 In a study by Wen et al, 5 the baseline prevalence of HPV DNA was similar in smokers and nonsmokers, and the authors suggested that the increased rate of progression of exophytic anogenital warts in smokers reflects immune modulation effects induced by cigarettes.…”