RESUMO
Background: Human papillomaviruses [HPVs] are small epitheliotropic DNA viruses that can induce cutaneous and mucosal lesions and appear to be closely linked to skin cancers. A broad variety of HPV types which have been referred to as epidermodysplasia verruciformis [EV] HPVs. It was found that patients with psoriasis revealed high prevalence of EV-associated HPV, suggesting that EV-HPV can act as putative antigen contributing to the pathogenesis of psoriasis. In particular, some viral genotypes HPV-5 and HPV-36 have been associated with psoriasis
Objective: To assess the presence of HPV-5 DNA in skin of psoriatic patients, its relation to disease severity by using PASI score and correlation with phototherapy treatment. Design: Screening for the presence of HPV-5 DNA sequences in skin biopsies and scrapings from psoriatic patients without treatment [group A], with history of Psoralen-ultraviolet A [PUVA] treatment [group B], with narrow band ultraviolet B [NB-UVB] [group C] and skin biopsies from control [group D]
Patients and methods: Samples were taken from 54 patients with plaque type psoriasis [39 men and 15 women, mean age 52.8 years] including 25 patients in group A, 15 patients in group B [mean number of PUVA exposure 140], 14 patients in group C [mean number of NB UVB exposure 60] and 15 subjects in group D. DNA was isolated from skin samples and analyzed by polymerase chain reaction with the use of 2 nested primer systems specific for HPV type 5
Results: The rate of HPV DNA positivity was significantly higher in patient groups than control group with a percentage of 24% [6/25] in group A, 33.33% [5/15] in group B, 28.5% [4/14] in group C and 6.6% [1/15] in group D [P=0.003 and X[2]=25.9]. There was a significant difference between lesional and non-lesional areas of psoriatic patients regarding HPV-DNA positivity with P < 0.0001 and X[2]= 16.98. PASI score was highly significant P < 0.001 between HPV-5 DNA negative, positive and double positive psoriatic patients
Conclusion: Skin of psoriatic patients was a reservoir for HPV-5. The prevalence was high in lesional than non-lesional areas, while HPV-5 negative subjects seemed to have a less severe disease. PUVA and NB UVB treatment for psoriasis in optimum doses are not associated with increasing HPV-5 in psoriatic patients