HPV in skin of psoriasis patients treated with medication and UV light therapy

CHICAGO – Patients with psoriasis who have been treated with a combination of drug (psoralen) and ultraviolet light therapy have an increased prevalence of human papilloma virus (HPV) in their skin, according to an article in the March issue of The Archives of Dermatology, one of the JAMA/Archives journals.

According to the article, treatment of psoriasis with the drug psorlaen plus ultraviolet A light therapy (PUVA) has been linked with an increased risk for developing skin cancer, but the exact causes of the increased risk are not well understood. HPV has been closely linked to skin cancer, and "It has been suggested that PUVA may increase expression of the tumorigenic [cancer-causing] agent HPV in skin by directly stimulating virus replication, immune suppression or both, thereby leading to skin cancer formation," the article states.

Peter Wolf, M.D., of Karl-Franzens-University, Graz, Austria, and colleagues examined whether the presence of HPV in the skin is increased after long-term PUVA treatment.

The researchers screened for HPV DNA in body hairs plucked from patients with psoriasis (81 patients, average age 52 years), including those with a history of PUVA exposure and a history of skin cancer (group A, n=16 patients, average of 702 PUVA exposures), PUVA exposure and no history of skin cancer (group B, n=35 patients, average of 282 PUVA exposures), and no PUVA exposure and no history of cancer (group C, n=30 patients).

The researchers found HPV DNA in 73 percent of patients (11 of 15) in group A; 69 percent of patients (24 of 35) in group B; and 36 percent of patients (10 of 28) in group C.

They conclude: "The prevalence of HPV in the skin (hair follicles) is increased in patients with psoriasis who have a history of PUVA exposure."

(Arch Dermatol. 2004;140:317-324. Available post-embargo at archdermatol.com)

Editor's Note: This work was supported by grants from the Austrian National Bank Jubilee Fund, Vienna (Dr. Wolf), and from the Cologne Center for Molecular Medicine, Cologne, Germany (Drs. Pfister and Fuchs). Dr. Seidl was supported as a postdoctoral fellow by a grant from the Austrian Science Foundation, Vienna (Fonds zur Forderung der Wissen Schafflichen Forschung).

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org .

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