Detection of Human Papillomavirus Type 58 in Polydactylous Bowen’s Disease on the Fingers and Toes of a Woman – Concurrent Occurrence of Invasive Vulval and Cervical Carcinomas

Abstract

The group related to human papillomavirus (HPV) type 16 (HPV-16, -31, -33, -35, -52, -58 and -67) is dominantly identified in cervical intraepithelial neoplasia and cervical carcinomas. HPV-16 has also been frequently detected in Bowen’s disease on the hands and feet. We describe herein a case of polydactylous Bowen’s disease on the fingers and toes of a woman who had had radical vulvectomy and hysterectomy for concomitant invasive vulval and cervical carcinomas. All the lesions, except for the lesions on the periungual side of her left index, middle and ring fingers, harbored HPV-58 DNA with more than 100 entire viral genome copies per cell detected by Southern blot hybridization. The histological localization of the viral DNA was confirmed in all the lesions by in situ hybridization. We could also retrospectively demonstrate HPV-58 DNA in her invasive vulval and cervical carcinoma tissues.

Detection of Human Papillomavirus Type 58 in Periungual Bowen�s Disease

“…It is of note that 3 out of 4 cases were BD of the fingers and toes (9)(10)(11). Hara et al (10) reported a case of polydactylous BD on the hands and feet that was clinically similar to our case. Longitudinal melanonychia is frequently associated with HPV type 56 infection, and thus some HPV genotype-phenotype correlation may exist between periungual BD and HPV type 58 infection, but the number of cases of HPV type 58 infection is still too limited to draw definitive conclusions.…”

“…Although the prevalence of HPV type 58 in cervical cancer was not limited to Japan and Asian countries (12), the HPV type 58-associated BD may have regionality, because 4 of these cases were from Japan (7,8,10,11). It is of note that 3 out of 4 cases were BD of the fingers and toes (9)(10)(11). Hara et al (10) reported a case of polydactylous BD on the hands and feet that was clinically similar to our case.…”

“…Only 5 cases of BD associated with HPV type 58 infection have been reported (7)(8)(9)(10)(11). Although the prevalence of HPV type 58 in cervical cancer was not limited to Japan and Asian countries (12), the HPV type 58-associated BD may have regionality, because 4 of these cases were from Japan (7,8,10,11). It is of note that 3 out of 4 cases were BD of the fingers and toes (9)(10)(11).…”

High-Risk Human Papillomavirus Infection in Bowen’s Disease of the Nail Unit: Report of Three Cases and Review of the Literature

“…Since the average age of α-HPV-16-positive women with cervical intra- epithelial neoplasia (CIN) grade 3 or invasive cancer is significantly lower as compared with HPV-16-negative groups [24], auto-inoculation of the finger from the genital area is an obvious explanation for the early onset of disease. In line, in 6 (30%) cases of affected women, the HPV type detected in ungual BD correlated with the type detected in vulvar intra-epithelial dysplasia (VIN) and/or CIN or even carcinomas [14,16,25,26,27,28]. However, the frequency of women affected by both BD of the nail unit and HPV-positive VIN/CIN is most likely higher, since data on the latter was largely missing in the reviewed literature.…”

“…In support of this idea, the right thumb of men, which is predominantly exposed to traumata or abrasion, followed by the second, third and fourth fingers in either gender are affected (table 2). Furthermore, cases of polydactylous disease have been reported, supporting a role of an infectious agent in periungual BD [14,15,16,17]. However, given the very low incidence of BD of the nail apparatus, additional predisposing factors may be needed for virus entry, e.g.…”