Low Rate of Detection of Mucosal High-Risk-Type Human Papillomavirus in Korean Patients with Extragenital Bowen's Disease and Squamous Cell Carcinoma, Especially in Digital Cases

Abstract

Human papillomavirus (HPV) infection has been demonstrated in some of the nonmelanoma skin cancers as well as in precancerous lesions. Multiple infections of mucosal high-risk HPV may contribute to the onset of digital Bowen's disease through, if any, digital-genital transmission. We screened for the presence of the mucosal HPV DNA in patients with extragenital Bowen's disease (n = 30), squamous cell carcinoma (n = 11), bowenoid papulosis (n = 9), verrucous carcinoma (n = 1), actinic keratosis (n = 5), and basal cell carcinoma (n = 5). We used a PANArray HPV Genotyping Chip for high-risk and low-risk mucosal types. Genotyping data was confirmed using a conventional direct DNA sequencing method. Two cases of extragenital Bowen's disease were positive for types 16 and 33 of mucosal HPV, respectively. None of the squamous cell carcinoma cases were positive. Neither patients with digital Bowen's disease (n = 5) nor those with squamous cell carcinoma (n = 3) showed any mucosal high-risk HPV. Mucosal high-risk HPV DNA was confirmed in 5 (55.6%) of the 9 patients with bowenoid papulosis. HPV 16 was most prevalent (n = 3), while the DNA of HPVs 35 and 67 was detected in one sample for each of the two types. Our study demonstrated that two (6.7%) of the patients with 30 extragenital Bowen's disease were positive for types 16 and 33 of mucosal HPV, respectively. HPVs belonging to the mucosal high-risk group may participate in the development of extragenital Bowen's disease. However, we could not find any relationship between the mucosal high-risk HPV and Bowen's disease or squamous cell carcinoma in the fingers.

Human papillomavirus infection and p16 expression in the immunocompetent patients with extragenital/extraungual Bowen’s disease

“…In our set of HPV-positive BD specimens, the β-papillomavirus genotypes predominated over α-papillomavirus genotypes, which is consistent with previous reports on BD/carcinoma in situ in both immunocompetent and immunocompromised patients [ 5 – 8 , 16 , 42 , 43 ]. Nevertheless, α-HPV genotypes were detected in significant proportion of BD lesions (~10 % of all BD lesions and ~29 % of HPV-positive BD lesions), which is in line with seven previous studies that examined the presence of only α-HPV genotypes in BD and reported in average 14.7 % of the HPV-positive BD cases (range 4.8–39 %) [ 13 , 15 , 23 , 24 , 45 – 47 ].…”

Human papillomavirus infection in Bowen disease: Negative p53 expression, not p16INK4a overexpression, is correlated with human papillomavirus‐associated Bowen disease

“…However, the reported prevalence of HPV in extragenital BD ranges 0-83%, and thus it is not clear to what extent HPV is involved in the pathogenesis of extragenital BD. [5][6][7][8][9][10][11][12][13][14] In this study, to determine the prevalence of HPV in BD, we examined 142 consecutively diagnosed (at our department) BD lesions for the mucous-type HPV. As a previous study showed that the use of a single PCR primer set for HPV detection is likely to underestimate the incidence of HPV-positive cancers, 27 we performed the PCR reactions using three different primer sets (GP5+/6+, L1C1/C2 and MY09/11) located in the L1 open reading frame.…”

“…3,4 Recently, cases of extragenital BD associated with mucous types of HPV also have been reported. [5][6][7][8][9][10][11][12][13][14] However, the detection rate of HPV in BD has varied among all reports, probably depending on the population studied and the sensitivity and specificity of the method used.…”

“…High‐risk mucous types of HPV also have been considered as an etiological agent in BD, especially on the genitalia . Recently, cases of extragenital BD associated with mucous types of HPV also have been reported . However, the detection rate of HPV in BD has varied among all reports, probably depending on the population studied and the sensitivity and specificity of the method used.…”

High-risk Mucosal Human Papillomavirus Infection in Squamous Cell Carcinoma and Bowen's Disease of the Hand

“…Available data on viral prevalence and type spectrum in these tumours are highly variable. Some studies show detection rates of mucosal HR-HPV in up to 90% (1)(2)(3)(4)(5), while others fail to detect viral DNA (6,7). Viral presence is reported to be confined to tumours on peri-and subungual sites, or predominantly on proximal phalanges rather than ungual sites (2,3).…”