DEVELOPMENT OF HUMAN PAPILLOMAVIRUS-ASSOCIATED BUSCHKE-LOWENSTEIN PENILE CARCINOMA DURING CYCLOSPORINE THERAPY FOR GENERALIZED PUSTULAR PSORIASIS

Buschke-Lowenstein-type giant penile condyloma developed in a human im munodeficiency virus-negative, 25-year-old man after 4 years of interm ittent cyclosporine therapy (5 mg/kg/day) for pustular psoriasis. Micr oscopic examination showed multifocal areas of invasive squamous cell carcinoma. Dot blot analysis of amplified polymerase chain reaction pr oducts with primers directed at the L1 region demonstrated signals for several human papillomavirus genotypes, including human papillomaviru s type 16, that correlated with different histologic patterns consisti ng of verrucous and bowenoid changes and invasive carcinoma. This case conforms to the enhanced risk of cutaneous carcinogenesis from either papillomavirus infection or chronic actinic damage that has become ev ident in patients with organ allografts and cyclosporine therapy.