Extragenital bowenoid papulosis associated with atypical human papillomavirus genotypes.
BACKGROUND
Bowenoid papulosis typically appears as grouped violaceous or red-brown papules in the genital or perianal regions and clinically resembles condylomata acuminata. Isolated extragenital bowenoid papulosis is rare and has been reported in only a few case reports.


OBJECTIVE
A 51-year-old immunocompetent, healthy woman had two solitary papules on the elbow; a 41-year-old HIV-positive man had a solitary cutaneous plaque on the abdomen. No genital, periungual, or other extragenital sites of involvement were noted in either patient. The diagnosis was confirmed histologically in both cases. Lesional skin from the female patient was tested with the Digenehybrid HPV DNA assay and was positive for a mixture of low-risk HPV subtypes (6, 11, 42, 43, 44). Lesional skin from the male patient was tested with polymerase chain reaction (PCR). Consensus primers targeted for the HPV L1 region, which is a highly conserved sequence common to more than 20 HPV subtypes encoding a viral capsid protein, were used. PCR using the consensus primers was positive, but type-specific probes for HPV types 6, 11, 16, 18, 45, 31, 33, 35, and 39 were negative.


CONCLUSIONS
To our knowledge, our male patient represents the first case of isolated bowenoid papulosis of the abdominal skin. Isolated upper-extremity bowenoid papulosis in our female patient is also a unique case in both location and involvement of low-risk HPV types (6, 11, 42, 43, 44), which have not been previously associated with extragenital bowenoid papulosis.
Papadopoulos
Anthony J
AJ
Dermatology, Pediatrics and Pathology, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07101-2714, USA.
Schwartz
Robert A
RA
Lefkowitz
Aza
A
Tinkle
Lily L
LL
Jänniger
Camilia K
CK
Lambert
W Clark
WC
D000005:Abdomen; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D004550:Elbow; D005260:Female; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D016133:Polymerase Chain Reaction; D012878:Skin Neoplasms / Q000821:virology*; D014412:Tumor Virus Infections / Q000175:diagnosis*
D004279:DNA, Viral