The prevalence of human papillomavirus DNA in benign keratotic skin lesions of renal transplant recipients with and without a history of skin cancer is equally high: A clinical study to assess risk factors for keratotic skinlesions and skin cancer

DNA of the epidermodysplasia-verruciformis associated subgroup of HPV (EV-N PV) is frequently detected in biopsies of premalignant lesions and nonmelan oma skin cancers of renal transplant recipients. The prevalence of EV-HPVs, however, has never been systematically studied in benign keratotic skin le sions of patients with or without a history of skin cancer. This study incl uded 42 renal transplant recipients with and 36 without a history of skin c ancer. A total of 176 skin biopsies were tested for the presence of EV-HPV DNA, using a nested polymerase chain reaction (PCR), Method. EV-HPV typing was done by comparison of the sequence of the amplifi ed PCR products with the sequence of all known EV-HPVs, The natural history of the development of keratotic skin lesions was studied, The number of ke ratotic skin lesions rapidly increased after transplantation. This increase was most pronounced in patients who developed skin cancer. The prevalence of EV-HPV DNA in benign keratotic skin lesions was equally high in patients With and without a history of skin cancer, i.e., 55 and 53% in the two gro ups, respectively, A large variety of EV-HPV types was found, but of these none were predominantly present in either patient groups. A higher prevalen ce of EV-RPV DNA was found in benign skin lesions from sun-exposed sites, b ut only in patients with a history of skin cancer, The association between the number of keratotic skin lesions and the development of skin cancer str ongly supports the hypothesis that EV-HPVs play a role in cutaneous oncogen esis, The equally high prevalence of EV-HPV infection in: patients with and without a history of skin cancer, however, may indicate that besides EV-HP V infection, other factors, such as sun exposure may also be important.