Distinctive distribution of human papillomavirus type 16 and type 20 DNA in the tonsillar and the skin carcinomas of a patient with epidermodysplasiaverruciformis

Background Epidermodysplasia verruciformis (EV) is a rare skin disease char acterized by disseminated pityriasis versicolor-like or flat wart-like lesi ons and by the development of skin carcinomas. It is well established that specific cutaneous human papillomaviruses (EV-HPVs) are associated with bot h benign and malignant skin lesions in EV patients. However, little is know n of the relationship between HPV and the mucosal lesions of EV patients. Objectives To detect and identify HPV types associated with skin and mucosa l lesions of an EV patient. Patient/methods We investigated the skin carcinoma and the coexisting tonsi llar carcinoma of a 41-year-old man with EV. Histopathologically, both lesi ons were squamous cell carcinomas. We analysed these two lesions by immunoh istochemistry, in situ hybridization, and by molecular virology. Results Neither skin nor tonsillar lesions exhibited positivity for HPV cap sid antigen by immunohistochemistry. By Southern blot hybridization, howeve r, the skin carcinoma harboured 'EV-specific' HPV20 DNA, while the tonsilla r carcinoma harboured 'genital' HPV16 DNA. In addition, in situ hybridizati on localized the respective viral DNA in the corresponding lesion. Conclusions The results indicate that EV-HPV could be responsible for the d evelopment of the skin carcinoma, but not the mucosal carcinoma in this pat ient.