Squamous cell carcinoma arising in association with verruca vulgares and HPV-2: a clinicopathologic study with p16 and p53 immunohistochemical studies and human papillomavirus in situ hybridization studies.

Background: We observed cutaneous squamous cell carcinomas of the skin (SCCS) with histologic features suggesting they are arising in association with verruca vulgares (SCC-VV). We analyzed SCC-VV to determine what types of human papillomaviruses (HPVs) could be detected by in situ hybridization. We also analyzed demographic and clinical features and performed immunohistochemical studies for p53, p16, and Ki-67.

Materials And Methods: Five cases of SCC-VV were chosen and compared with 5 cases each of cutaneous squamous cell carcinoma with bowenoid features (SCC-BD), and cutaneous squamous cell carcinoma with keratoacanthomatous features (SCC-KA).

Results: We identified HPV-2 in 3 of 5 SCC-VV and SCC-KA, and 2 of 5 SCC-BD. SCC-VV showed a decreased amount of p16 immunoexpression compared with the other types, particularly SCC-BD (P=0.0108 ). SCC-KA showed a decreased p53 (P=0.0096) and Ki-67 (P=0.0007) immunoexpression compared with the other types.

Conclusions: SCC-VV seems to occur in older immunocompetent individuals and may be distinguishable from other SCCS types by histologic and immunohistochemical methods. HPV-2 and HPV-1 were the only types of HPV identified in this study, including SCCS with such diverse morphologic appearances as SCC-VV, SCC-BD, and SCC-KA. Further studies are needed to confirm these findings.