High-risk human papillomavirus infection in Bowen's disease of the nail unit: report of three cases and review of the literature.

BACKGROUND

Bowen's disease (BD) of the nail unit is associated with human papillomavirus (HPV) infection.

OBJECTIVE

This study aimed to investigate the frequency of high-risk HPV infection, gender, age and digital distribution in this condition.

METHODS

Biopsy specimens of 3 consecutive cases with periungual BD were investigated for the presence of HPV DNA by in situ hybridization and by polymerase chain reaction (PCR). Furthermore, 74 cases of ungual BD conducted with HPV genotyping as reported in the literature were reviewed.

RESULTS

PCR of biopsy specimens revealed in 2 cases infection with HPV-16 and in 1 case with HPV-73. Additionally, in 1 HPV-16-positive case HPV-31/33 was detected by in situ hybridization. In line, review of the literature demonstrated a clear association of HPV-positive BD with high-risk HPV types. Interestingly, age at diagnosis was significantly lower in women. Whereas in both genders the second to fourth fingers on both hands were commonly diseased, only in men the thumbs were also prominently affected.

CONCLUSIONS

Infection with high-risk HPV types is common in BD of the nail unit suggesting the aetiological cause. Therefore, patients and partners should be closely followed up for digital and genital HPV-associated lesions.