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15 September 2007

Volume 196, Number 6
The Journal of Infectious Diseases 2007;196:876–883
0022-1899/2007/19606-0011$15.00
DOI: 10.1086/521031
MAJOR ARTICLE

Cutaneous Human Papillomaviruses Found in Sun‐Exposed Skin: Beta‐papillomavirus Species 2 Predominates in Squamous Cell Carcinoma

Ola Forslund,1

Thomas Iftner,6

Kristin Andersson,1

Bernt Lindelöf,3

Eva Hradil,2

Peter Nordin,4

Bo Stenquist,5

Reinhard Kirnbauer,8

Joakim Dillner,1 and

Ethel‐Michele de Villiers,4 for the

Viraskin Study Groupa

1Department of Medical Microbiology, Malmö University Hospital, Lund University, and 2Department of Dermatology, Malmö University Hospital, Malmö, 3Department of Dermatology, Karolinska University Hospital, Stockholm, and 4Dermatology Clinic, Läkarhuset, and 5Department of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden; 6Medical Virology, Section of Experimental Virology, University Hospital of Tübingen, and 7Division of Tumourvirus Characterization, Deutsches Krebsforschungszentrum Heidelberg, Germany; 8Laboratory of Viral Oncology, Division of Immunology, Allergy and Infectious Diseases, Medical University Vienna, Austria

Background.A spectrum of cutaneous human papillomaviruses (HPVs) is detectable in nonmelanoma skin cancers, as well as in healthy skin, but the significance that the presence of these types of HPV DNA has for the pathogenesis of skin cancer remains unclear.

Methods.We studied 349 nonimmunosuppressed patients with skin lesions (82 with squamous cell carcinomas, 126 with basal cell carcinomas, 49 with actinic keratoses, and 92 with benign lesions). After superficial skin had been removed by tape, paired biopsy samples—from the lesion and from healthy skin from the same patient—were tested for HPV DNA. Risk factors for HPV DNA were analyzed in multivariate models.

Results.Overall, 12% of healthy skin samples were positive for HPV DNA, compared with 26% of benign lesions, 22% of actinic keratoses, 18% of basal cell carcinomas, and 26% of squamous cell carcinomas. HPV DNA was associated with sites extensively exposed to the sun, both for the lesions (odds ratio [OR], 4.45 [95% confidence interval {CI}, 2.44–8.11]) and for the healthy skin samples (OR, 3.65 [95% CI 1.79–7.44]). HPV types of Beta‐papillomavirus species 2 predominate in squamous cell carcinomas (OR, 4.40 [95% CI, 1.92–10.06]), whereas HPV types of Beta‐papillomavirus species 1 are primarily found in benign lesions (OR, 3.47 [95% CI, 1.72–6.99]).

Conclusions.Cutaneous HPV types are primarily detected at sites extensively exposed to the sun. HPV types of Beta‐papillomavirus species 2, but not of species 1, are associated with squamous cell carcinoma.

Received 1 February 2007; accepted 3 April 2007; electronically published 6 August 2007.

Reprints or correspondence: Ola Forslund, Medical Microbiology, Entrance 78, UMAS, SE‐20502 Malmö, Sweden ().

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  • Potential conflicts of interest: none reported.

    Presented in part: 23rd International Papillomavirus Conference, Prague, Czech Republic, 6 September 2006 [abstract PS 28‐6].

    Financial support: European Commission (grant “Viraskin” QLK2‐CT‐2002‐01500); Swedish Research Council; Swedish Cancer Society.

  • Study group members are listed after the text.

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