Verrucous Carcinoma of the Scalp Associated with Human Papillomavirus Type 33

Abstract

Background Verrucous carcinoma (VC) is a low-grade, well-differentiated squamous cell carcinoma of the skin or mucosae, and human papillomavirus (HPV) infection has been considered to be one of the causative factors of VC at three main sites, including the oral cavity, the genitoanal region, and the foot. However, the relationship between cutaneous VC at other sites and HPV infection remains obscure. Objective We describe a rare case of cutaneous VC originating in a burn scar on the scalp and our attempt to find HPV infection in the lesion. Methods We investigated the presence of HPV by polymerase chain reaction–restriction fragment length polymorphisms and immunohistochemical analysis. Results HPV type 33 was detected in the lesion, and positive stains for HPV were observed in several cell nuclei at the upper stratum malpighi. Conclusion Since HPV type 33, as well as HPV types 16 and 18, is regarded as a high-risk, mucosal type, HPV type 33 infection likely contributed to the development of the lesion. We suggest that HPV infection should be relevant to a subset of cutaneous VC.