The histologic spectrum of epidermodysplasia verruciformis in transplant and AIDS patients.
BACKGROUND
The purpose of this study was to correlate the histologic findings of skin lesions clinically suspicious for epidermodysplasia verruciformis with the viral findings in patients with organ transplants or AIDS.


METHODS
Thirty-seven skin biopsies from 17 patients (six with AIDS and 11 with transplants) were studied as a non-randomized, controlled, unblinded case series by in situ hybridization for HPV DNA.


RESULTS
Nineteen (51%) of these biopsies were HPV-positive by in situ hybridization either for HPV type 5 (five cases), type 8 (10 cases), type 16 (four cases) or HPV 31 (one case, with one case of dual infection). Only eight of the 19 HPV-positive tissues (42%) showed the classic histologic features of verruca planae. The more common histologic feature significantly associated with HPV detection was a focally thickened and disrupted granular layer (13/19 [68%] vs. 8/18 [44%], p < 0.04). Dysplasia was evident in 12/19 HPV-positive tissues (63%), which was significantly greater than in patients with congenital epidermodysplasia verruciformis (20%).


CONCLUSIONS
Oncogenic HPV types are detected in about one-half of skin biopsies from immunocompromised patients with a clinical presentation suspicious for epidermodysplasia verruciformis. Many of these lesions lack the histologic features of verruca planae, a focally thickened granular layer is a marker for viral detection, and the risk for dysplasia in such lesions is much higher than in epidermodysplasia verruciformis not associated with acquired immunosuppression.
Department of Pathology, Ohio State University Medical Center, Columbus, 43210, USA
Carl
C
Morrison
Yehuda
Y
Eliezri
Cynthia
C
Magro
Gerard J
GJ
Nuovo
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis*; D004819:Epidermodysplasia Verruciformis / Q000150:complications / Q000276:immunology / Q000473:pathology* / Q000821:virology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000235:genetics; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000473:pathology*; D016133:Polymerase Chain Reaction; D012867:Skin / Q000473:pathology* / Q000821:virology; D014180:Transplantation; D014412:Tumor Virus Infections / Q000473:pathology*
D004279:DNA, Viral