Detection of human papillomavirus type 10 DNA in eccrine syringofibroadenomatosis occurring in Clouston's syndrome

Syringofibroadenomatosis is often associated with an underlying condition s uch as diabetes mellitus or hidrotic ectodermal dysplasia. By reason of the se associations, a reactive or hamartomatous cause is suspected. We report a case of a 71-year-old woman with Clouston's syndrome in whom progressive multiple palmoplantar syringofibroadenomas developed over a 10-year period. The syringofibroadenomas formed flat-topped papules simulating verruca pla na; the widespread distribution and chronic progressive course resembled ep idermodysplasia verruciformis. Contiguous with the syringofibroadenoma's ch aracteristic epithelial-stromal proliferation were epidermal changes of ver ruca plana, Evidence of human papillomavirus (HPV) infection was verified b y immunolabeling with antibodies to bovine papillomavirus type 1 and detect ion of HPV 10 viral DNA by means of polymerase chain reaction. Rather than a hamartomatous process, these findings suggest that syringofibroadenomas o ccurring in the setting of Clouston's syndrome could represent an HPV-induc ed epithelial proliferation.