Ed. Hsi et al., DETECTION OF HUMAN PAPILLOMAVIRUS DNA IN KERATOACANTHOMAS BY POLYMERASE CHAIN-REACTION, The American journal of dermatopathology, 19(1), 1997, pp. 10-15
The etiology of keratoacanthomas is unknown, but human papillomavirus
(HPV) has been suspected to be involved in the pathogenesis of this le
sion because koilocytic changes may be observed and because HPV has be
en found in cutaneous squamous-cell carcinomas and premalignant kerato
ses in immunosuppressed patients. We analyzed DNA extracted from 39 ke
ratoacanthomas from 22 ''at-risk'' patients (nine patients undergoing
UV light and/or anthralin therapy for psoriasis, 10 solid organ transp
lant recipients, one patient with xeroderma pigmentosa, one patient wi
th acquired immunodeficiency syndrome, and one patient undergoing ther
apy for non-Hodgkin's lymphoma) for the presence of HPV. The results w
ere compared with analyses of DNA extracted from 30 keratoacanthomas f
rom 28 patients at no known increased risk for these lesions. Using po
lymerase chain reaction (PCR) primers designed to detect multiple HPV
types (including 6, 11, 16, 18, 31, and 33), HPV was detected in seven
keratoacanthomas from six of the at-risk patients and in eight sporad
ic keratoacanthomas from eight patients without risk factors. HPV was
also present in one of 26 nonlesional skin controls. Statistical analy
sis showed a significant difference in the prevalence of HPV DNA seque
nces found in keratoacanthomas compared to normal control skin (p = 0.
038). The presence of virus by PCR could not be predicted by histologi
c evaluation. Sequence analysis showed the presence of HPV types 11, 1
3, 24, 33, and 57. Although these results confirm the frequent presenc
e of HPV in keratoacanthomas, the role of this virus in the etiology a
nd pathogenesis of these lesions remains to be elucidated.