Controversy exists about the meaning of human papillomavirus (HPV) detection in seborrheic keratosis (SK). To clarify the pathogenic contributing role of HPV in the development of genital SK, we have studied 40 genital SKs, 20 extragenital SKs, and 20 non-SK genital lesions by polymerase chain reaction for HPV, using a Linear Array Genotyping test that detects 37 genital HPV types. Twenty-eight of the 40 genital SK specimens (70%) were positive for HPV. Twenty-seven of the 28 positive cases (96%) contained HPV6, one of them associated to HPV18 and HPV35 (4%), and the remaining lesion (4%) harbored HPV55. However, HPV was detected in only 2/20 extragenital SK samples (10%) and in 1/20 non-SK genital lesions (5%). Our results support a pathogenic relationship between HPV and genital SK by showing: 1) a high rate of virus detection in these lesions, with a strong predilection for HPV6, and 2) scarcity of genital HPV types in most of the remaining non-SK cutaneous genital lesions and in the extragenital SKs. HPV cannot be found in a minority of genital SKs using highly sensitive techniques, and therefore, other presently unknown factors may also be implied in the pathogenesis of these lesions.

Nevus lipomatosus superficialis (NLS) is an uncommon hamartomatous lesion of the skin characterized by the presence of clusters of mature fat cells among the collagen bundles of the dermis. Usually, the number of adnexal structures is reduced in NLS as compared to the normal adjacent skin, but their morphology is not altered. Nevertheless, in some instances, associated pilar abnormalities have been reported. We here report 2 cases of NLS with disorganized pilosebaceous units. The follicular structures were dilated and showed infundibular type keratinization and there were numerous mature sebaceous lobules radiating from them resembling the histology of a folliculosebaceous cystic hamartoma (FSCH) or a sebaceous trichofolliculoma. Only 2 cases of NLS with FSCH have been previously reported. Our cases represent examples of a very rare hamartomatous cutaneous lesion composed of mesenchymal and epithelial components.

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Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) are round-cell sarcomas with varying degrees of neuroectodermal differentiation; they are considered members of the same family of tumors based on their common genetic profile. ES/PNET are very infrequent in the female genital tract, the vagina being the rarest gynecological location, with 7 cases reported to date. The authors present a case of vaginal ES/PNET with typical morphological and immunohistochemical features. EWS gene rearrangement was demonstrated by fluorescent in situ hybridization analysis. Of the 7 previously reported cases, only 2 have molecular confirmation. The age at presentation for vaginal ES/PNET is slightly higher than that for these neoplasms in bone and soft tissues, with only 1 reported patient younger than 30 years. The outcome seems to be similar to that of other superficially sited ES/PNET and more favorable than for those observed in the more typical locations. However, the currently available data are limited, and therefore, a larger number of cases is necessary to draw any firm conclusions.

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