Detection Of High - Risk Human Papillomavirus Type 16/18 In Cutaneous Warts In Immunocompetent Patients, Using Polymerase Chain Reaction

摘要

Cutaneous warts are caused by human papillomavirus (HPV). Prevalence studies of the types of HPV present in cutaneous warts have been carried out more frequently in immunosuppressed patients. The present study was designed to study the association of high-risk HPV in cutaneous warts of immunocompetent patients. A total of 45 cases of cutaneous warts from various sites in immunocompetent subjects were analysed for HPV. Samples included both archival material i.e. paraffin embedded and fresh tissue. Highly sensitive and comprehensive polymerase chain reaction (PCR) methodology for detection of HPV of high oncogenic potential, HPV 16/18 was employed. HPV 16 was detected in 3 (6.6%) patients. None of the lesion demonstrated HPV 18. None of the cutaneous warts demonstrated histopathological features associated with dysplasia or neoplasia. The identification of HPV 16 in cutaneous warts which are benign proliferation of the skin further expands the spectrum of HPV linked lesions. It remains of critical interest to determine whether these types are specifically associated with the development of malignant lesions analogous to those seen in anogenital cancer. Introduction Human papillomavirus (HPV) appears to be the most ubiquitous of the human viruses. Over 100 HPV types have been identified. Majority of HPV infect the skin of normal s well as immunocompromised individuals. In normal people, most of these HPV appear to establish a latent infection of the skin most likely as normal flora residing in hair follicles. A minority of HPV cause cutaneous warts and mucosal condylomata [1]. Warts or verrucae are benign proliferations of the skin, cutaneous warts (verrucae vulgaris), flat warts (verruca plana), plantar warts, mosaic warts and butcher's warts. HPV may have a role in promoting proliferating lesions of the skin, although their site of active infection and mode of transmission to susceptible individuals remains unknown.HPV is an epitheliotrophic virus and is inoculated into the viable epidermis through defects in the epithelium. Only a few HPV types of low and intermediate oncogenic potential have been recognised in cutaneous warts. The more frequent HPV types found in lesions of cutaneous common warts in general population are HPV types 2, 57, 27, 4 and 1 [2,3]. There is paucity of data on the association of mucosotropic HPV of high oncogenic potential with cutaneous wart. The present study aims to analyse the association of HPV 16/18 in the cutaneous warts in immunocompetent patients. Material and Methods Forty five cases of clinically diagnosed cutaneous warts and subsequently histologically proven verrucous lesion were recruited from January to December 2004. Lesions were considered as common warts if the lesions presented with compact hyperkeratosis, acanthosis, papillomatosis, hypergranulosis, elongated and flattened dermal papillae bend inwards towards the centre of the lesion and enlargement of the capillaries (figure 1).