ROLE OF HUMAN PAPILLOMAVIRUS IN CUTANEOUS ONCOGENESIS

There is a strong association between the human papillomavirus and cut aneous squamous cell carcinoma. If this association was merely random, one would expect an equal distribution of human papillomavirus types among affected individuals. However, only specific types of human papi llomavirus are consistently found in cutaneous and genital squamous ce ll carcinomas. Immunosuppressed individuals clearly have a much higher incidence of cutaneous carcinomas. Immunosuppression, either local or systemic, not only decreases immune surveillance but may also dictate the amount and type of virus each individual may carry. Epidermodyspl asia verruciformis and other rare hereditary disorders that combine sp ecific immune defects and an increased incidence of malignancy are ver y useful models that clearly fulfill a multistep theory of oncogenesis . The precise mechanism of oncogenesis in these select human papilloma virus types is not yet fully understood. Intracellular interactions wi th the recently described tumor suppressor proteins may prove to be th e primary site of action of these oncogenic viruses. Environmental coc arcinogens and activation of oncogenes are clearly important if not es sential factors in human papillomavirus-associated tumors. As our know ledge and understanding of malignant transformation grows, it becomes apparent that this is a complex multistep process.