Human papillomavirus in cutaneous squamous cell carcinoma and cervix of a patient with psoriasis and extensive ultraviolet radiation exposure

"High-risk" human papillomaviruses (HPVs) are associated with intraepitheli al neoplasia and cancer of the uterine cervix. HPV has also been found in n onmelanoma skin cancer (NMSC), especially in squamous cell carcinomas (SCCs ) of immunosuppressed patients. Recently, lesions of psoriasis have been sh own to harbor HPV and patients with psoriasis often have a history of exten sive therapy with ultraviolet radiation (UNR). UVR is the major known risk factor in the occurrence of NMSC, in which HPV may be a cofactor for SCC. W e report an otherwise healthy, nonimmunosuppressed patient with psoriasis w ho had a history of extensive exposure to UVR and experienced multiple SCCs on W-exposed body sites. By the polymerase chain reaction method, we detec ted HPV in 5 of 9 SCCs. Automated sequencing showed HPV types 12 and 17. On ly 1 of 3 normal skin specimens was HPV positive (HPV type 17). This positi ve specimen was from UV-exposed skin; one of the two HPV-negative, normal s kin specimens was located on a body site not exposed to sun. In addition, H PV type 62 was found in a brush specimen of the uterine cervix. This case r eport suggests an association between psoriasis, HPV infection, and UVR exp osure, in onset of SCC.