Increased prevalence of human papillomavirus in hairs plucked from patients with psoriasis treated with psoralen-UV-A.
BACKGROUND
Patients with psoriasis treated with psoralen-UV-A (PUVA) are at increased risk of skin cancer; however, the exact causes of this increased incidence are not well understood. It has been suggested that PUVA may increase expression of the tumorigenic agent human papillomavirus (HPV) in skin by directly stimulating virus replication, immune suppression, or both, thereby leading to skin cancer formation.


OBJECTIVE
To determine whether HPV DNA prevalence in the skin is increased after long-term PUVA treatment.


METHODS
Screening for the presence of HPV sequences in DNA isolated from plucked body hairs of patients with psoriasis with a history of PUVA exposure and a history of skin cancer (group A), PUVA exposure and no history of skin cancer (group B), and no PUVA exposure and no history of skin cancer (group C).


METHODS
University hospital.


METHODS
Hair samples were obtained from 81 patients with psoriasis (56 men and 25 women; mean age, 52 years), including 16 in group A (mean number of PUVA exposures, 702), 35 in group B (mean number of PUVA exposures, 282), and 30 in group C. DNA was isolated from the hair samples and analyzed by polymerase chain reaction with the use of 2 nested primer systems specific for epidermodysplasia verruciformis-associated or related and genital or mucosal virus types, respectively.


RESULTS
The rate of HPV DNA positivity was significantly higher in groups A (73% [11/15]) and B (69% [24/35]) than in group C (36% [10/28]) (A + B vs C, P =.009; chi(2) test; age adjusted). Conclusion The prevalence of HPV in the skin (hair follicles) is increased in patients with psoriasis who have a history of PUVA exposure.
Wolf
Peter
P
Department of Photodermatology, Karl-Franzens-University, Graz, Austria. peter.wolf@kfunigraz.ac.at
Seidl
Hannes
H
Bäck
Barbara
B
Binder
Barbara
B
Höfler
Gerald
G
Quehenberger
Franz
F
Hoffmann
Christine
C
Kerl
Helmut
H
Stark
Sabine
S
Pfister
Herbert J
HJ
Fuchs
Pawel G
PG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005363:Ficusin / Q000008:administration & dosage; D006197:Hair / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000009:adverse effects*; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D015995:Prevalence; D011565:Psoriasis / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*
D004279:DNA, Viral; D017319:Photosensitizing Agents; D005363:Ficusin