Human papillomavirus infection and non-melanoma skin cancer in immunosuppressed and immunocompetent individuals

The role of human papillomavirus (HPV) in anogenital carcinogenesis is esta blished firmly, but a similar role in non-melanoma skin cancer remains spec ulative. Certain immunosuppressed individuals have an increased incidence o f both viral warts and non-melanoma skin cancer, that has prompted the sugg estion that HPV may play a pathogenic role. Differences in the techniques u sed to detect HPV DNA in skin, however, have led to discrepancies in the pr evalence and spectrum of HPV types reported in these malignancies. This stu dy describes the use of a comprehensive degenerate PCR technique to compare the HPV status of 148 Non-melanoma skin cancers from immunosuppressed and immunocompetent individuals. HPV DNA was detected in 37/ 44 (84.1%) squamou s cell carcinomas, 18/24 (75%) basal cell carcinomas and 15/17 (88.2%) prem alignant skin lesions from the immunosuppressed group compared with 6/22 (2 7.2%) squamous cell carcinomas, 11/30 (36.7%) basal cell carcinomas and 6/1 1 (54.4%) premalignancies in the immunocompetent group. Epidermodysplasia v erruciformis HPV types prevailed in all lesion types from both groups of pa tients. In immunosuppressed individuals, cutaneous HPV types were also iden tified at high frequency, and co-detection of multiple HPV types within sin gle tumours was commonly observed. This study represents the largest and mo st comprehensive analysis of the HPV status of non-melanoma skin cancers ye t undertaken; whereas there are clearly significant differences in non-mela noma skin cancers from immunosuppressed and immunocompetent populations, we provide evidence that the prevalence and spectrum of HPV types does not di ffer in squamous cell carcinomas, basal cell carcinomas or premalignancies within the two populations. These data have important implications for futu re investigation of the role of HPV in cutaneous carcinogenesis at a functi onal level. (C) 2000 Wiley-Liss, Inc.