Verrucous pilar cysts infected with beta human papillomavirus

Nanes, Benjamin A.; Laknezhad, Soolmaz; Chamseddin, Bahir; Doorbar, John; Mir, Adnan; Hosler, Gregory A.; Wang, Richard C.

doi:10.1111/cup.13599

Cited by 8 publications

(17 citation statements)

References 34 publications

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“…Rupture of the capsule of the cyst, or imbalances between matrix metalloproteinases and their tissue inhibitors, could result in inflammation of the cyst, which would warrant delayed surgical excision [ 3 , 12 ]. Cysts may be infected with the human papillomavirus [ 13 ]. Calcification of the cyst, producing radio-opacity on radiographs, has also been reported [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Pilar Cyst Over the Volar Aspect of the Thumb: A Case Report and Review of Literature

Ramanujapuram,

Parameswaran,

Mohammed

et al. 2024

Cureus

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Pilar cysts are derived from the outer layer of the root sheath of hair follicles. They were conventionally thought to arise from hair-bearing skin like the scalp. However, this notion has been refuted recently. Pilar cysts of the hand are extremely rare, with only a few case reports in the literature. We report the case of a 40-year-old male patient, with no known medical co-morbidities, who presented with a swelling over his left thumb. It was occasionally painful, and caused difficulty in grasping objects. Physical examination revealed a 2.5 x 1.5 cm swelling over the volar aspect of the thumb, at the level of the proximal phalanx. MRI revealed the presence of a well-defined cystic lesion superficial to the flexor tendons. The possibility of an epidermal cyst was considered, and the patient was advised surgery in view of his symptoms and progression in the size of the swelling. He underwent excision of the lesion along with a segment of adherent skin. Histopathological examination of the lesion revealed the presence of a pilar cyst. The patient did not have recurrence of symptoms following surgery, and was found to be doing well at the three-year follow-up. This case report urges a re-thinking of the possible origins of pilar cysts from atypical locations.

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Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Pilar Cyst Over the Volar Aspect of the Thumb: A Case Report and Review of Literature

Ramanujapuram,

Parameswaran,

Mohammed

et al. 2024

Cureus

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“…The histopathology depicted in select cases (Figures A,D, and especially F) described by Nanes et al is suggestive of hypergranulotic dyscornification within a cyst and may explain why six of eight of their cases were negative for HPV by polymerase chain reaction or immunohistochemistry …”

Section: Introductionmentioning

confidence: 86%

“…We read with great interest the case series by Nanes et al We hope to explore whether some of the “verrucous pilar cysts” that they report may alternatively have histopathologic features of hypergranulotic dyscornification , which we have recently described in an epidermoid cyst and in a series of 29 solitary keratoses. All our cases were negative for human papillomavirus (HPV) infection as showed by an anti‐HPV immunohistochemical stain (BPV‐1/1H8 + CAMVIR, ab2417; Abcam, Cambridge, MA), although this antibody does not detect beta‐HPV types …”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus‐related verrucous cysts and hypergranulotic dyscornification within a cyst are likely distinct entities

Roy

McNiff

2019

J Cutan Pathol

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portion of these cysts). These anucleate corneocytes may be interpreted by some as koilocytic haloes but lack nuclei on careful inspection. Some of these latter cases may represent HD rather than HPVrelated cytopathic change in the cyst wall. A limitation of our series 2 of HD is that we used immunohistochemistry alone to detect HPV, and not all subtypes of HPV are detectable using that method. HPV detection in other reported cases of HD, to the best of our knowledge, was not attempted and could be an area of further research inquiry.Hence, we argue that HPV-induced changes in a pilar cyst are similar to HPV-related epidermoid cysts but can be mimicked by the incidental occurrence of hypergranulotic dyscornification within a cyst. We posit that some of the cases reported by Nanes et al, particularly the hybrid cysts shown to contain HPV by various methods, fit well with verruous pilar cysts infected with HPV, and that other cases in their series showing prominent geometric keratohyaline granules with an unusual pattern of maturation and absence of detectable HPV may represent hypergranulotic dyscornification in a cyst. Moreover, other verrucous cysts in the literature lacking HPV may also represent the phenomenon of HD within a cyst. We thank Nanes and colleagues for working to further our collective understanding and diagnosing of the spectrum of histologic and pathogenic findings in so-called verrucous cysts.

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“…These types of cysts share histopathologic features of HPV and have a stratified squamous epithelium lining. [1][2][3] Verrucous cysts are most commonly epidermoid (infundibular) in origin. However, trichilemmal cysts have also been described in the literature.…”

Section: To the Editormentioning

confidence: 99%

“…However, trichilemmal cysts have also been described in the literature. 1,4,5 Verrucous epidermoid cysts are commonly found on the trunk, face, and neck and occur equally in both sexes. 3,6 Histology is characteristic for an acanthotic epidermis with typical verrucous features such as papillated epithelium, hypergranulosis with dense keratohyalin globules and orthokeratosis and parakeratosis.…”

Section: To the Editormentioning

confidence: 99%