High prevalence of a variety of epidermodysplasia verruciformis-associatedhuman papillomaviruses in psoriatic skin of patients treated or not treated with PUVA

Epidermodysplasia verruciformis-associated human papillomaviruses and in pa rticular human papillomavirus type 5 were recently shown to be highly preva lent in psoriatic skin. We have analyzed lesional skin from 54 psoriasis pa tients for infections with genital-specific and epidermodysplasia verrucifo rmis-specific human papillomaviruses to define the spectrum of involved hum an papillomavirus types and to test if it is influenced by psoralen ultravi olet A therapy. Using polymerase chain reaction analysis we could detect hu man papillomavirus sequences in skin lesions of 83% of the tested patients. In contrast, human papillomavirus-DNA was only demonstrated in 19% of skin samples from 42 dermatologically healthy, immunocompetent individuals. Seq uence analysis of the polymerase chain reaction amplimers revealed 14 human papillomavirus types, all belonging to the epidermodysplasia verruciformis or epidermodysplasia verruciformis-related papillomaviruses. Only in one c ase we identified sequences related to those of genital viruses, which, how ever, represented a putatively new human papillomavirus type. The most prev alent human papillomavirus type in our patient series was human papillomavi rus type 36, found in 62% of the patients positive for human papillomavirus -DNA, followed by human papillomavirus type 5 (38%) and human pagillomaviru s type 38 (24%). Multiple infections with two to five different human papil lomavirus types could be detected in skin samples of 63% of the analyzed pa tients. The overall human papillomavirus detection rate did not differ sign ificantly between patients which have been subjected to psoralen ultraviole t A photochemotherapy or solely treated with topical preparations (77 vs 89 %), Human papillomavirus type 5, however, could be detected significantly m ore frequent in lesions of psoralen ultraviolet A-treated patients (p < 0.0 01). Our data strongly argue for infections with epidermodysplasia verrucif ormis-specific papillomaviruses being an almost consistent feature of the l esional psoriatic skin and substantiate the importance of further studies t o elucidate a possible involvement of human papillomaviruses in psoriasis p athology.