“…The presence of genital HPVs in cutaneous lesions or tissues has also been described by others [10, 11, 13, 16]. HPV type 16 has been found in more than 60% of periungual SCC [25], but also sporadically in SCC of patients receiving PUVA therapy [13, 26, 27]. HPV-16 infections of the anogenital tract are known to have a high risk for malignant transformation and may also be oncogenic in cutaneous tissues.…”
Background: The association of human papillomavirus (HPV) with cutaneous squamous-cell carcinomas (SCCs) has been described recently, but the frequency and spectrum of HPV types identified differed substantially in distinct studies. Objective: Comparison of different PCR assays with respect to sensitivity and range of HPV types detected. Method: Cutaneous SCC were analyzed for HPV DNA using both consensus PCR assays with degenerate primers and PCR assays with nondegenerate primers derived from HPV types 5 and 8. Results: HPV DNA was found in 50% of SCC specimens using degenerate primers. The rate of HPV-DNA-positive specimens increased to 69% when PCR assays with nondegenerate primers were applied in addition. The spectrum of HPV types detected with each of the PCR assays differed considerably. Conclusions: The frequency and spectrum of HPV types detected in cutaneous SCC strongly depends on the HPV detection system used and urges the need for standardization of HPV detection and typing in skin lesions in order to characterize HPV types predominating in distinct tumors.
“…The presence of genital HPVs in cutaneous lesions or tissues has also been described by others [10, 11, 13, 16]. HPV type 16 has been found in more than 60% of periungual SCC [25], but also sporadically in SCC of patients receiving PUVA therapy [13, 26, 27]. HPV-16 infections of the anogenital tract are known to have a high risk for malignant transformation and may also be oncogenic in cutaneous tissues.…”
Background: The association of human papillomavirus (HPV) with cutaneous squamous-cell carcinomas (SCCs) has been described recently, but the frequency and spectrum of HPV types identified differed substantially in distinct studies. Objective: Comparison of different PCR assays with respect to sensitivity and range of HPV types detected. Method: Cutaneous SCC were analyzed for HPV DNA using both consensus PCR assays with degenerate primers and PCR assays with nondegenerate primers derived from HPV types 5 and 8. Results: HPV DNA was found in 50% of SCC specimens using degenerate primers. The rate of HPV-DNA-positive specimens increased to 69% when PCR assays with nondegenerate primers were applied in addition. The spectrum of HPV types detected with each of the PCR assays differed considerably. Conclusions: The frequency and spectrum of HPV types detected in cutaneous SCC strongly depends on the HPV detection system used and urges the need for standardization of HPV detection and typing in skin lesions in order to characterize HPV types predominating in distinct tumors.
“…Weinstock et al 20 described a 58-year-old male psoriatic patient who developed multiple keratotic papules, predominantly on the thighs and legs, over a 15-year period during which he underwent a 10-year course of PUVA. Eighty biopsies over this period revealed 14 KAs, 13 SCCs, 8 KA vs. SCC, 2 KA vs. verucca, 26 verucca vulgares, 10 actinic keratoses, 6 BCCs, and 1 melanomain-situ.…”
We believe that UV radiation is the most likely etiologic factor in this patient's development of multiple keratoacanthomas. We wish to bring to the attention of clinicians this unusual adverse effect of UV treatment.
“…[12] Prolonged therapy with PUVA or UVB has also been seen to result in large number of KAs. [2345] Infective factors, especially viral, cannot be excluded as a cause. Various authors have found HPV-related DNA in KAs.…”
A 22 year old male psoriatic patient presented with multiple reddish scaly plaques all over body. After hematological and biochemical investigations the patient was started on oral methotrexate 15 mg weekly. PASI score at the start of treatment was 26.2. After 3 months PASI dropped to 11.5, the dose of methotrexate was tapered to 7.5mg weekly and the patient was maintained on this dose and kept under monthly follow up. Four months later, the patient presented with reddish to hyperpigmented raised firm nodules having a central crater over the healing plaques of psoriasis. Few lesions showed self resolution over a period of 6-12 weeks. Histopathology of the lesion confirmed it to be Keratoacanthoma. We believe the most likely etiologic factors for the multiple KAs in our patient could be a genetic susceptibility stimulated by multiple causes.
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