ReviewUngual and periungual human papillomavirus–associated squamous cell carcinoma: A review
Introduction
The oncogenic role of human papillomavirus (HPV) in squamous cell carcinoma (SCC) has been well established. Outside the genital region, HPV-associated tumors are found primarily on the hands and feet, particularly in the area of the nail bed. We review reports of HPV-associated carcinoma of the digit, particularly in the area of the nailbed, as well as the epidemiological factors, clinical associations, and management of these tumors.
Section snippets
Methods
A literature search was performed on MEDLINE, PubMed, and Ovid. Manuscripts were reviewed to identify reports of HPV-associated SCC and SCC in situ in the ungual and periungual regions. Citations were reviewed to avoid potential oversight of older manuscripts. Initially, we limited our search to reports with at least 10 cases; however, because there were few case series in the literature, we expanded the search to include any report of HPV-associated SCC. Key words searched include HPV, ungual,
Results
Our review identified 103 patients reported in the English-language literature with HPV-associated digital SCC or SCC in situ (Bowen's disease) over a 26-year period (1983-2009). More than 50 reports of subungual and periungual SCC without HPV typing studies were excluded. There were 120 individual tumors on the fingers and toes. Fifteen cases did not specify the affected digit, and 23 reports did not indicate a specific location on the digit. Fourteen cases did not specify the hand on which
Discussion
The strongest evidence for the oncogenic role of HPV lies in SCC of the cervix, which is virtually always associated with high-risk mucosal HPV subtypes.44 Outside the genital area, HPV-associated cutaneous SCC and SCC in situ are seen in epidermodysplasia verruciformis and immunocompromised patients, such as in those undergoing kidney transplantation or those with HIV infection. In immunocompetent patients, the majority of cutaneous malignancies associated with HPV outside the genital area
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Funding sources: None.
Conflicts of interest: None declared.