Mucosal human papillomavirus detection and TP53 immunohistochemical expression in non‐melanoma skin cancer in Tunisian patients

Ayed, I. Ben; Tounsi, H.; Jaballah, A.; Ardhaoui, M.; Maaloul, Afifa; Lassili, Thalja; Mezghani, Najla; Abdelhak, Sonia; Boubaker, Samir

doi:10.1111/cup.13473

Cited by 11 publications

(10 citation statements)

References 38 publications

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“…HPVs predominantly appear to be β-HPV types, 5 emerging reports now identify HPV 16 and 18 DNA in some KC. 3,4 Our patient's striking response, as well as results reported by Nichols et al, may imply the presence of these viral subtypes in reported patients' lesions. Alternatively, immunization against certain HPV types might confer crossprotection against others, as reported for genital HPV.…”

supporting

confidence: 82%

Reduction in actinic keratoses following 9‐valent human papilloma virus vaccination

Wenande

Bech-Thomsen²,

Hædersdal

2020

Dermatologic Therapy

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This observational report examines the use of 9-valent human papilloma virus (HPV) vaccination as adjunctive, off-label management of actinic keratosis (AK). We describe the case of a 78-year-old immunocompetent Caucasian woman with an extensive history of histologically verified AK, seen at a private dermatological practice. For the past decade, the patient had received regular treatments for multiple AKs every 3 months, including cryotherapy, red light photodynamic

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supporting

confidence: 82%

Reduction in actinic keratoses following 9‐valent human papilloma virus vaccination

Wenande

Bech-Thomsen²,

Hædersdal

2020

Dermatologic Therapy

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“…The mechanism behind HPV vaccine-mediated effects on AKs and KCs is unknown. Previously, β-HPVs were theorized to play a role in the initiation phase of skin carcinogenesis, possibly via the deleterious effects of viral oncoproteins, E6 and E7 [ 3 , 11 , 12 , 13 ]. In light of this theory, the question remains why a vaccine targeting mucosal α-HPVs would provide near-universal effects in our AK population.…”

Section: Discussionmentioning

confidence: 99%

“…In light of this theory, the question remains why a vaccine targeting mucosal α-HPVs would provide near-universal effects in our AK population. Among the vaccine-associated types, HPV16 is only occasionally detected in skin lesions [ 3 ]. AKs instead primarily harbor β-HPVs, which in turn exhibit marked variation in type between lesions and individuals [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…An association between skin dysplasia and human papillomavirus (HPV) has long been suspected. Raising suspicion of a potential relationship, the prevalence of viral DNA and mRNA is reported in actinic keratoses (AKs) as well as keratinocyte carcinomas (KCs) [ 1 , 2 , 3 ]. Risk of skin cancer is higher in immunosuppressed populations, with HPV DNA detection approaching 90% in KCs of immunosuppressed versus 30–50% in immunocompetent groups [ 2 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Off-Label 9-Valent Human Papillomavirus Vaccination for Actinic Keratosis: A Case Series

et al. 2021

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Background: The suspected link between human papillomavirus (HPV) and the development of premalignant and malignant skin lesions remains inadequately examined in clinical settings. This case series describes HPV vaccination as an off-label adjuvant therapy for actinic keratosis (AK). Methods: Twelve immunocompetent AK patients underwent HPV vaccination at a private dermatology clinic in Naestved, Denmark. Prior to vaccination, all patients demonstrated a high AK burden that required regular control visits. At 0, 2, and 6 months, the patients received an intramuscular injection of a commercially available 9-valent HPV vaccine. Concurrently, patients continued conventional AK therapies at 3-month intervals. Clinical response, consisting of reduction in AK number and general change in skin appearance, was assessed by a dermatologist over 12 months following first vaccination. Results: All patients (mean age 76.2 years; 10 M and 2 F) completed the vaccine schedule. Overall, an average 85% reduction in total AK burden was recorded 12 months after beginning vaccination. Median AK burden thus fell from 56 (IQR: 44–80) to 13.5 (IQR: 1–18) lesions after 12 months. Lesion reduction was observable by the second inoculation at month 2 (34 AKs; IQR 22–80), continuing steadily until month 6 (15 AKs; IQR 5–30) and plateauing between 6 and 12 months. Clinically, HPV vaccination elicited fading of lesions’ erythematous background after the first dose, often followed by sloughing of hyperkeratotic elements in subsequent weeks. Patients reported no adverse effects related to HPV vaccination. Conclusion: This case series introduces the possibility that 9-valent HPV vaccination in combination with conventional treatments may be used as a therapeutic strategy for AK.

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“…Notably, in a previous retrospective study, high‐risk mucosal HPV types (type 16, 31, 35, and 51) were detected in patients with nonmelanoma skin cancer (NMSC), suggesting that high‐risk genital HPV‐type infection may also represent a risk factor for NMSC in the nonimmunosuppressed population [13]. A high prevalence of mucosal HPV types in NMSC biopsy specimens was revealed in a Tunisian study, associated with loss of p53 function [14].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Human Papillomavirus Infection on Skin Cancer: A Population-Based Cohort Study

et al. 2020

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Background This study investigated the correlation between a history of human papillomavirus (HPV) infection and skin cancer risk. Materials and Methods The study cohort comprised 26,919 patients with newly diagnosed HPV infection between 2000 and 2012; with the use of computer‐generated numbers, patients without previous HPV infection were randomly selected as the comparison cohort. The patients in the HPV infection cohort were matched to comparison individuals at a 1:4 ratio by demographic characteristics and comorbidities. All study individuals were followed up until they developed skin cancer, withdrew from the National Health Insurance program, were lost to follow‐up, or until the end of 2013. The primary outcome was subsequent skin cancer development. Cox proportional hazards regression analysis was used to analyze the risk of skin cancer with hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort. Results The adjusted HR of skin cancer for patients with HPV relative to controls was 2.45 after adjusting sex, age and comorbidities. (95% CI, 1.44–4.18, p < .01). The subgroup analysis indicated that a patient with HPV infection had a significantly greater risk of skin cancer if they were aged >40 years. Notably, a risk of skin cancer was found in the group diagnosed with HPV within the first 5 years after the index date (adjusted HR, 3.12; with 95% CI, 1.58–5.54). Sensitivity analysis by propensity score, matching with balanced sex, age, and comorbidities, showed consistent results. Conclusion A history of HPV infection is associated with the development of subsequent skin cancer in Taiwanese subjects, and the risk wanes 5 years later. Implications for Practice In this Taiwan nationwide cohort study, there was a 2.45‐fold increased risk of developing new‐onset skin cancers for patients with incident human papillomavirus (HPV) infection, compared with the matched controls. Furthermore, the risk was noticeably significant among patients aged >40 years. A prominent risk of skin cancers was found in the group diagnosed with HPV within the first 5 years after the index date in this study. The results of this analysis may raise consensus on the effect of HPV infection on the risk of skin cancers. Clinicians are encouraged to implement prudently on the differential diagnosis of skin cancers and HPV prevention and treatment, especially in older patients.

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Mucosal human papillomavirus detection and TP53 immunohistochemical expression in non‐melanoma skin cancer in Tunisian patients

Cited by 11 publications

References 38 publications

Reduction in actinic keratoses following 9‐valent human papilloma virus vaccination

Reduction in actinic keratoses following 9‐valent human papilloma virus vaccination

Off-Label 9-Valent Human Papillomavirus Vaccination for Actinic Keratosis: A Case Series

The Impact of Human Papillomavirus Infection on Skin Cancer: A Population-Based Cohort Study

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