Detection of Human Papillomavirus in Nongenital Bowen's Disease by In Situ DNA Hybridization

Abstract

Genital Bowen's disease has been strongly linked in recent studies to human papillomavirus (HPV). Nongenital Bowen's disease has been less well investigated, although isolated reports, all of which involved detection of HPV after extraction of DNA from fresh-frozen tissue, have been made. We investigated 25 cases of nongenital Bowen's disease in 5 black and 20 white patients for the presence of HPV types 1, 6, 11, 16, and 18 using paraffin-embedded tissues. Human papillomavirus was present in six specimens from 3 of the 5 black patients (one previously reported to be positive on Southern blot) and 3 of the 20 white patients; HPV 16 was detected in all 6 cases on low-stringency testing, but only 4 remained positive on high-stringency testing. This suggests an HPV closely related to but not entirely homologous with HPV 16 in the 2 remaining cases. Five of the 6 positive specimens were lesions from the hands and feet and 1 was from the volar aspect of the arm. Clinical factors associated with the presence of HPV included black race, location on the palmar surface and the feet, young age, and verrucous or hyperkeratotic clinical appearance. Of the 6 positive cases, all 5 of the patients available for examination also had evidence of HPV-associated genital lesions. No specific histopathologic features were found to be indicative of the presence or absence of HPV.

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

“…Aetiological factors for SCC in situ include (i) irradiation: ultraviolet radiation (solar, iatrogenic and sunbeds) 14,18 and radiotherapy; (ii) carcinogens: arsenic (lesions may arise in sun-protected areas) 19 ; (iii) immunosuppression: in particular, therapeutic 20,21 ; (iv) viral: there is an association between human papillomavirus (HPV), especially HPV16, and the development of anogenital SCC in situ, [22][23][24] but this is by no means conditional for its development. 25 HPV DNA has been demonstrated in extragenital SCC in situ in varying amounts from 4Á8-60%.…”

Id2 protein is selectively upregulated by UVB in primary, but not in immortalized human keratinocytes and inhibits differentiation

“…UV and HPV thus likely play roles in the early immortalization stage of carcinogenesis. While HPV-16 is implicated in anogenital cancer, between 16 and 25% of nongenital Bowen's disease of the skull, foot, and periungual regions of the finger is associated with HPV-16 (Guerin-Reverchon et al, 1990;Kettler et al, 1990). These sites are potential targets of solar radiation, and the latter lesion represents a significant fraction of all skin cancer cases (Eliezri et al, 1990).…”

Detection of Human Papillomavirus Type 16 in Bowen's Disease of the Web-space of the Foot

“…These three cases including our own had similar clinical features with pigmented, hyperkeratotic macules. However, the previously described lesions have been multiple, well circumscribed and verrucous plaques (3, 4), a type also described by Kettler et al (9).…”