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

BackgroundHuman papillomavirus (HPV) is ubiquitous on the skin of normal and immunosuppressed hosts.ObjectiveWe describe the diversity of HPV types in skin specimens using PCR-sequencing directly and after cloning with FAP59/64 or HVP2/B5 primers.Study designCross-sectional analysis of skin swabs.ResultsSeventy-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.ConclusionHPV 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.