CLINICAL, HISTOPATHOLOGIC, AND MOLECULAR ASPECTS OF CUTANEOUS HUMAN PAPILLOMAVIRUS INFECTIONS
Section snippets
INTRODUCTION TO MOLECULAR ASPECTS OF HPV
Human papillomaviruses (HPVs) comprise a large family of double-stranded DNA viruses of approximately 8 kilobases that are the etiologic agents of benign warts and anogenital cancers. At least 82 different HPV types have been identified, and many remain yet uncharacterized. The development of new molecular techniques in recent years has led to an increased understanding of HPVs and their roles in carcinogenesis. The human papillomaviruses are broadly grouped into mucosal and cutaneous types,
Epidemiology
Condyloma acuminatum, also known as genital wart or venereal wart, is an increasingly common sexually transmitted disease with an annual incidence of approximately 1%.116 The increasing incidence, attributed to increased sexual promiscuity, particularly among young people, is supported by a peak prevalence in persons between the ages of 17 and 33 years and a peak incidence in persons from ages 20 to 24 years.116, 117 Studies report a steady increase in the frequency of childhood condylomata
Epidemiology and Clinical Manifestation
The condition only later termed bowenoid papulosis61, 131 was first described by Lloyd72 as “multicentric pigmented Bowen's disease of the groin.” The disease occurs predominantly in young, sexually active adults averaging 20 to 35 years old.39 In this condition, men and women present with multiple wartlike brown-red papules (7 mm in average diameter) in the anogenital region that histologically resemble in situ squamous cell carcinoma.39 Sometimes, the papules become confluent and coalesce.
Clinical Manifestations
Verruca vulgaris or common warts are circumscribed, rough, hard nodules and plaques with an irregular, scaly surface most commonly involving the hands, fingers, and knees with a predilection for the distal digits and palms (Fig. 3).5, 6 Other less common sites of involvement include soles of the feet, oral mucosa, face, esophagus and larynx.8, 35, 107 They occur as solitary or multiple, endophytic or exophytic lesions predominantly seen in children and adolescents. The lesions can grow to a
Epidemiology
Epidermodysplasia verruciformis (EV) is a rare genodermatosis in which there is life-long infection with specific HPVs considered harmless to the general population and a predisposition to develop squamous cancers in adult life.52, 77, 78, 79 Epidermodysplasia verruciformis carries a worldwide distribution with no apparent racial or geographic preference. Lesions develop in early childhood with malignant transformation in approximately half of patients during adulthood. This pattern of disease
Epidemiology
Focal epithelial hyperplasia (FEH) of the oral mucosa, also referred to as Heck's disease, was first reported in a Native American population and described in the dental literature by Archard, Heck, and Stanley in 1965.84 North, South, and Central Native Americans and Eskimos have a predisposition for this condition, with a high prevalence reported in these populations.40 Similar cases have been reported in Italy, Britain, Africa, Iran, Venezuela, and Spain.18, 36, 40, 48, 64, 88, 101, 125
Clinical Manifestations
Palmoplantar or myrmecial warts present as thick endophytic plaques typically on the palms and/or soles. There is a prediliction for pressure points such as the heel, metatarsal heads, and toes (Fig. 5). Lesions tend to be deep-seated and covered by a thick callus. They are often referred to as myrmecia because of their resemblance to an anthill.19 Brown dots representing thrombosed capillaries distinguish them from calluses, corns, or exostoses. Another simulant is black heel (talon noir),
Epidemiology
Verruca plana or flat warts most commonly develop during the second decade of life.109 Multiple HPV subtypes are associated with plane warts, although HPV 3 is most common. Renal transplant patients have a high incidence of flat warts, with the most common types being HPV 5 and HPV 49.34, 104 Immunosuppressed patients, including those with non-Hodgkin's lymphoma81 and HIV,104 may have numerous lesions. One study noted a remarkably high prevalence of flat warts among employees in a large meat
CONCLUSION
Human papillomaviruses consist of myriad phylogenetic subtypes that cause a spectrum of human disease ranging from harmless common warts to anogenital cancers. Recent advances in molecular biology have expanded the understanding of HPV oncogenesis and have spurred the development of new therapeutic modalities. Advances in the next decade will no doubt further clarify several unclear yet important issues, among which are
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the immunologic defect in epidermodysplasia verruciformis
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the
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2021, Anais Brasileiros de DermatologiaCitation Excerpt :Consequently, there would be a stimulus for epithelial hyperplasia that would result, from the histopathological point of view, in acanthosis and papillomatosis.4 The histopathological characteristics of verruca vulgaris or common warts are evident in the epidermis, where the presence of acanthosis, papillomatosis, marked hyperkeratosis, and parakeratosis columns can be observed on the top of the epithelial cones, with the absence of the granular layer that is accentuated in the valleys between adjacent cones.5 In the areas of parakeratosis, small accumulations of blood or serosity can be observed.6
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2015, Seminars in Diagnostic PathologyTowards the detection of human papillomavirus infection by a reagentless electrochemical peptide biosensor
2011, Electrochimica ActaCitation Excerpt :Human papillomavirus (HPVs) is a group of non-enveloped, double stranded DNA virus composed of more than 100 genotypes which are responsible of genital and cutaneous warts [1,2].
Cutaneous viral diseases
2011, Revista Medica Clinica Las CondesHuman papillomavirus infection
2006, FMC Formacion Medica Continuada en Atencion PrimariaPenile cancer
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Address reprint requests to Lyndon D. Su, MD, University of Michigan, Department of Pathology and Dermatology, 1301 Catherine, Medical Science Bldg 1, M5224, Ann Arbor, MI 48109–0054
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Department of Pathology and Dermatology, University of Michigan School of Medicine, Ann Arbor, Michigan (NF, LL, LS); and the Department of Anatomic Pathology, City of Hope Hospital, Duarte, California (SW)