Diversity of cutaneous human papillomavirus types in individuals with and without skin lesion

Background: Human papillomavirus (HPV) is ubiquitous on the skin of normal and immunosuppressed hosts. Objective: We describe the diversity of HPV types in skin specimens using PCR-sequencing directly and after cloning with FAP59/64 or HVP2/135 primers. Study design: Cross-sectional analysis of skin swabs. Results: Seventy-five (92.6%) of 81 subjects provided samples that could be analysed with PCR (34 healthy controls < 50 years old, 13 healthy controls > 50 years old, 12 with actinic keratosis (AK), 8 with squamous cell carcinoma (SCC) and 8 renal transplant recipients). HPV DNA was detected more frequently with FAP59/64 (68/75, 91%) than with HVP2/B5 (9/75, 12%) (p < 0.001). Agreement of typing results using FAP59/64 primers with both sequencing strategies was fair (mean kappa 0.56 +/- 0.19, 95% CI: 0.46-0.65). HPV species 1 and 2 of the beta-papillomavirus genus were associated with the presence of AK (OR= 24.8, 95% CI: 2.3-262.6). A greater number of HPV types per sample was found in individuals with AK or SCC (p = 0.046) or AK alone (p = 0.02), than in healthy participants. Conclusion: HPV infection on the skin is best evaluated with a combination of primers and sequencing strategies. Novel putative types were frequently detected in SCC. Skin lesions have a greater number of HPV types than normal skin. (c) 2006 Elsevier B.V. All rights reserved.