title: Role of human papillomaviruses in cutaneous and oral manifestations of immunosuppression.
abstract: Long-term immunosuppressive drug regimes, used to prevent organ transplant rejection, are associated with an increased risk of epithelial malignancies particularly anogenital and cutaneous cancers. Premalignant and malignant lesions of the oral mucosa have also been reported in renal transplant recipients (RTRs), particularly of sun-exposed lip lesions. Many of these anogenital lesions are associated with the detection of high-risk mucosal human papillomaviruses (HPV). Novel degenerate and nested polymerase chain reaction (PCR) techniques have found high levels of epidermodysplasia verruciformis (EV) HPVs (high-risk cutaneous oncogenic HPVs) in cutaneous warts, dysplastic keratoses, and squamous cell carcinomas. Unusual appendageal and spindle cell carcinomas are being observed in RTRs. Increasing survival times of HIV-positive patients may be associated with dysplasia of orogenital mucosal epithelium, and careful epidemiologic studies of cutaneous lesions are needed. The role of HPVs in the development of these lesions has yet to be established.
authors.affiliation: Imperial Cancer Research Fund Skin Tumour Laboratory, Clinical Sciences Research Centre, St. Bartholomew's and Royal London School of Medicine and Dentistry, UK.
authors.forename: I M
authors.initials: IM
authors.lastname: Leigh
authors.forename: J A
authors.initials: JA
authors.lastname: Buchanan
authors.forename: C A
authors.initials: CA
authors.lastname: Harwood
authors.forename: R
authors.initials: R
authors.lastname: Cerio
authors.forename: A
authors.initials: A
authors.lastname: Storey
mesh_terms: D000328:Adult; D004819:Epidermodysplasia Verruciformis / Q000276:immunology / Q000821:virology; D015658:HIV Infections / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D009059:Mouth Diseases / Q000276:immunology / Q000821:virology; D009061:Mouth Mucosa / Q000276:immunology* / Q000821:virology; D016377:Organ Transplantation; D027383:Papillomaviridae / Q000302:isolation & purification; D012871:Skin Diseases / Q000276:immunology* / Q000821:virology; D012878:Skin Neoplasms / Q000276:immunology / Q000821:virology; D014860:Warts / Q000276:immunology / Q000821:virology
chemical_list: D007166:Immunosuppressive Agents