Mucosal human papillomavirus types in squamous cell carcinomas of the uterine cervix and subsequently on fingers

Abstract

Human papillomavirus (HPV), especially type 16, is causally involved in the pathogenesis of anogenital cancer. There is an increasing number of reports of HPV infections in squamous cell carcinoma (SCC) of the fingers. A search of the Swedish cancer register covering the period 1958-94 inclusive for women with a history of genital and upper extremity SCC revealed 63 cases. Archival material from both cervical and cutaneous lesions was traced and analysed for the presence of HPV DNA in 32 of these patients. A newly developed 'neighbour primer' polymerase chain reaction (PCR) for HPV 16 DNA, aimed at overcoming the obstacle of cross-linked target DNA, was shown to be superior to conventional general and type-specific HPV PCR tests. HPV DNA was significantly more frequently found in digital tumours than in tumours at other cutaneous sites of the upper extremities [67% (10 of 15) vs. 7% (three of 43); P < 0.001]. Among 13 patients with a history of both cervical and finger SCC, HPV 16 was found in cervical samples from seven patients. From five of these seven patients, HPV 16 was also present in the corresponding finger lesions. The results support the hypothesis of a possible transmission of patients' genital HPV infections to fingers.

Digital squamous cell carcinoma and association with diverse high-risk human papillomavirus types

“…17 These high-risk strains are usually mucosal, and HPV-16 in particular is rarely detected in tumors of the skin in locations other than the digit. 5 HPV infections of the fingers are much less common than cervical HPV infection and most likely represent a late event as a result of low efficiency of transmission. 5 However, HPV-16 specifically has been detected in as many as 53% 5 to 94% of cases of digital SCC.…”

“…Previously reported cases have also been associated with low-risk HPV-2 and -26, and highrisk HPV-18, -34, and -35. 1,5,9,[11][12][13][14][15] 7 because of their ability to immortalize human keratinocytes and their strong association with cervical carcinoma and intraepithelial neoplasia. 11,16 In a study of 5696 women, HPV-16, -31, and -33 conveyed the highest risk for cervical dysplasia.…”

“…SCCs of the distal digit and periungual skin, however, appear to be an exception, with mounting evidence to suggest that SCCs in this location are overwhelmingly associated with the mucosal oncogenic HPV subtypes, especially HPV-16. 1,5,6 Overall, as many as 90% of digital SCCs are HPV associated. 1 …”

Dermatologic manifestations of HPV in HIV-infected individuals

“…In some studies, HPV-16 has been detected in up to 94% of cases, with closely related types 26, 34, and 35 also reported [46,50,51•]. These HR strains are usually confi ned to mucosal sites, and HPV-16 in particular is rarely detected in tumors of the skin in locations other than the digit [49]. Interestingly, all three reported cases of HPV-26-related digital SCC have been in HIV-positive patients [35,51•], suggesting that immunosuppression may predispose to acquisition of infection by this unusual HPV type [51•].…”

“…1D) are overwhelmingly associated with the highly oncogenic, mucosal HPV subtype-16 [47,49]. Overall, roughly 90% of digital SCC is HPV associated [50].…”