α- and β-Papillomavirus infection in a young patient with an unclassified primary T-cell immunodeficiency and multiple mucosal and cutaneous lesions

• Published in: Journal of the American Academy of Dermatology Vol. 71; no. 1; pp. 108 - 115.e1
• Main Authors: Landini, Manuela M., PhD, Borgogna, Cinzia, PhD, Peretti, Alberto, PhD, Colombo, Enrico, MD, Zavattaro, Elisa, MD, PhD, Boldorini, Renzo, MD, Miglio, Umberto, PhD, Doorbar, John, PhD, Ravanini, Paolo, MD, Kumar, Rajesh, PhD, Moratto, Daniele, MD, Badolato, Raffaele, MD, De Andrea, Marco, MD, PhD, Gariglio, Marisa, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2014
• Subjects: Adult; Alphapapillomavirus - classification; Alphapapillomavirus - genetics; Betapapillomavirus - genetics; Betapapillomavirus - isolation & purification; Condylomata Acuminata - virology; Dermatology; DNA, Viral - analysis; Flow Cytometry; Genotype; Hair - virology; Humans; Immunologic Deficiency Syndromes - complications; Immunologic Deficiency Syndromes - virology; Lymphopenia - immunology; Male; Mucous Membrane - virology; papillomavirus; Papillomavirus Infections - complications; Papillomavirus Infections - diagnosis; Papillomavirus Infections - pathology; Papillomavirus Infections - virology; primary immunodeficiency; Primary Immunodeficiency Diseases; Real-Time Polymerase Chain Reaction; skin cancer; viral carcinogenesis; viral life cycle; skin cancer; fluorescent in situ hybridization; MCM7; papillomavirus; PID; warts, hypogammaglobulinemia, infections, and myelokathexis; HPV; EV; viral life cycle; epidermodysplasia verruciformis; human papillomavirus; primary immunodeficiency; FISH; viral carcinogenesis; minichromosome maintenance protein 7; WHIM; PCR; polymerase chain reaction
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2014.01.859

Background Correlating human papillomavirus (HPV) type with the clinical and histopathological features of skin lesions (from genital and nongenital sites) can present a diagnostic challenge. Objective In this study, HPV infection patterns were correlated with pathology and clinical presentation in lesional and nonlesional body sites from a young patient with a primary T-cell immunodeficiency. Methods HPV infection was evaluated at both DNA and protein levels by polymerase chain reaction and immunohistochemistry. Results The patient’s genital lesions were caused exclusively by α-genotypes (high-risk type HPV-51 in the anal and low-risk type HPV-72 in the penile condylomas). The opposite was true for the skin lesions, which were infected by β-genotypes alone (HPV-8 and HPV-24). HPV-24 was the predominant type in terms of viral load, and the only one found in productive areas of infection. The patient had already developed high-grade dysplasia in the anal condyloma-like lesions, and showed areas of early-stage dysplasia in the lesions caused by the β-genotype HPV-24. Limitations The basic origin of the immunodeficiency is not yet defined. Conclusion These findings provide proof of principle that both α- and β-genotypes can cause overt dysplastic lesions when immunosurveillance is lost, which is not restricted to epidermodysplasia verruciformis.