Case and Research Letters
Human Papilloma Virus and the Risk of Squamous Cell Carcinoma Arising in Hidradenitis Suppurativa
Virus del papiloma humano y riesgo de desarrollo de carcinoma escamocelular en la hidradenitis supurativa
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C, Subcorneal pustule with abundant neutrophils (hematoxylin-eosin x200).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. García Abellán, J. Matarredona Catalá, A. Jaen Larrieu, I. Valencia Ramírez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "García Abellán" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Matarredona Catalá" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Jaen Larrieu" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Valencia Ramírez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017306737" "doi" => "10.1016/j.ad.2017.10.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017306737?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301380?idApp=UINPBA000044" "url" => "/15782190/0000010900000005/v1_201806040407/S1578219018301380/v1_201806040407/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219018301306" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.04.011" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "1813" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2018;109:455-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 57 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 52 "PDF" => 4 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Atrophying Pityriasis Versicolor" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "455" "paginaFinal" => "457" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pitiriasis versicolor atrófica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1350 "Ancho" => 900 "Tamanyo" => 127228 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Slightly depressed hypopigmented and pink plaques of various sizes on the patient's back. 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"apellidos" => "Zulaica" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017305410" "doi" => "10.1016/j.ad.2017.08.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017305410?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301306?idApp=UINPBA000044" "url" => "/15782190/0000010900000005/v1_201806040407/S1578219018301306/v1_201806040407/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Human Papilloma Virus and the Risk of Squamous Cell Carcinoma Arising in Hidradenitis Suppurativa" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "457" "paginaFinal" => "459" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.M. Segura Palacios, P. García Montero, R. Fúnez Liébana, J.B. Repiso Jiménez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J.M." "apellidos" => "Segura Palacios" "email" => array:1 [ 0 => "juanmanuelo_1983@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "P." "apellidos" => "García Montero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "Fúnez Liébana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "J.B." "apellidos" => "Repiso Jiménez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Costa del Sol, Marbella, Málaga, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Virus del papiloma humano y riesgo de desarrollo de carcinoma escamocelular en la hidradenitis supurativa" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1400 "Ancho" => 1867 "Tamanyo" => 774607 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Well-differentiated squamous cell carcinoma covering the fistulous tract. B, Expansive growth pattern of squamous cell carcinoma in greater detail. C, Areas with a koilocytic appearance. D, Extensive nuclear and cytoplasmic positivity to p16.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 51-year-old man who was referred to the dermatology department with a painful, suppurative nodule in his left groin that had appeared 1 year previously and was refractory to various antibiotic regimens prescribed by his primary care physician. The patient had a personal history of type 2 diabetes mellitus and was a smoker. Physical examination revealed an erythematous subcutaneous lesion with areas of suppuration in the lower left groin. On palpation, the lesion extended to the perineal region (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The examination also revealed 3 lesions that were clinically compatible with condylomata acuminata in the perianal area. He was diagnosed clinically for hidradenitis suppurativa (HS). Ultrasonography with an 18-MHz linear probe revealed the presence of a fistulous tract, with areas of fluid collection, together with intense vascularization on Doppler mode (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Given the location and depth of the lesion, the patient was sent to the clinic of the surgery department for complete removal of the lesion. Histopathology showed changes that were compatible with HS and well-differentiated squamous cell carcinoma (SCC) over the fistulous tract, which was located close to the deep resection margin. No vascular invasion or perineural infiltration was observed (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> A and B). Extension of the surgical margins revealed no evidence of residual tumor, although foci suggestive of viral infection were observed (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>C). Immunohistochemical staining with p16 was intensely positive (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>D). Polymerase chain reaction and genotyping based on in situ hybridization with a microarray of paraffin-embedded tissue were performed to investigate the presence of human papillomavirus (HPV). The result was positive for genotype 6 (considered low risk); the same finding was recorded for the perianal condylomata acuminata. Laboratory analysis yielded negative results for HIV and hepatotropic viruses. After a 12-month clinical and imaging-based follow-up (computed tomography and magnetic resonance imaging of the pelvis), the patient showed no signs of local recurrence or metastasis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">During the last few decades, there have been reports of cases of carcinomatous transformation in HS in the perineal, perianal, and gluteal region. Of particular interest is the review of Lagoviez et al.,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> who report 13 new cases and investigate the presence of HPV in 8 histology samples. According to the literature, the condition predominantly affects men. This observation is logical, given that the locations of HS reported above are typical in men.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A key question in this disease at present is whether malignant degeneration occurs more frequently in the perianal or gluteal region owing to HPV infection in these areas. The virus seems to be implicated in the pathogenesis of SCC through oncogenic expression.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> This has also been reported in the development of other types of intraepithelial neoplasia and tumors in the anogenital region, affecting the penis, scrotum, and anal, vulvar, and vaginal areas.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,5</span></a> Twenty years ago, Li et al.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> first put forward the hypothesis that HPV played an important role in the SCC that arises in HS, although they did not perform a histopathology analysis.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> However, in a later study, Lagoviez et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> investigated the presence of HPV in 8 anogenital tumors using polymerase chain reaction. The results were positive in all 8 samples, both for the low-risk genotypes (HPV-6) and for the high-risk genotypes (HPV-16 and 68). It was recently demonstrated that even HPV genotypes that are low-risk may be involved per se in the development of anogenital SCC.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Flores et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> observed a significant positive correlation in HPV-16 viral load between nearby sites of infection, such as the anal canal and the perianal area or the perianal area and the scrotum, or sites that are in regular contact in a resting position. Therefore, previously uninfected genital areas could become inoculated by infections at nearby anatomical sites through direct contact and facilitated by environmental factors such as humidity, temperature, and, possibly, poor hygiene.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Furthermore, the advent of anti–tumor necrosis factor therapy in HS has led various authors to recommend investigating the presence of lesions suggestive of HPV in these areas, since there have even been reports of deaths resulting from the development of SCC after initiation of this therapy.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Both ultrasound and magnetic resonance imaging could prove useful for confirmation of the true anatomical extension of the disease before surgery.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Wide excision of the lesion is considered the standard treatment. SCC that arises in areas of chronic inflammation caused by HS is often well differentiated. Nevertheless, despite this theoretically good histologic prognosis, we can observe rapid growth, local aggressiveness, early metastasis, and high mortality.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The case we report supports the relevant role of HPV in the development of SCC in patients with HS in the inguinal, perineal, and perianal areas.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Segura Palacios JM, García Montero P, Fúnez Liébana R, Repiso Jiménez JB. Human Papilloma Virus and the Risk of Squamous Cell Carcinoma Arising in Hidradenitis Suppurativa. Actas Dermosifiliogr. 2018;109:457–459.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1200 "Ancho" => 900 "Tamanyo" => 225871 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left inguinal-perineal lesion with an erythematous area that was indurated to the touch. Note the presence of an associated condylomatous lesion in the perianal area.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 978 "Ancho" => 2334 "Tamanyo" => 179742 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, B mode, 18-MHz probe. The presence of a fistulous tract in the subcutaneous cellular tissue and a fluid collection area can be observed. B, Doppler study showing intense vascularization inside the fistulous tract.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1400 "Ancho" => 1867 "Tamanyo" => 774607 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Well-differentiated squamous cell carcinoma covering the fistulous tract. B, Expansive growth pattern of squamous cell carcinoma in greater detail. C, Areas with a koilocytic appearance. D, Extensive nuclear and cytoplasmic positivity to p16.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological study of 13 cases of squamous cell carcinoma complicating hidradenitis suppurativa" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Lavogiez" 1 => "E. Delaporte" 2 => "S. Darras-Vercambre" 3 => "E. Martin de Lassalle" 4 => "C. Castillo" 5 => "X. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 10 | 5 | 15 |
| 2024 Octubre | 82 | 40 | 122 |
| 2024 Septiembre | 99 | 17 | 116 |
| 2024 Agosto | 134 | 53 | 187 |
| 2024 Julio | 122 | 38 | 160 |
| 2024 Junio | 92 | 31 | 123 |
| 2024 Mayo | 117 | 34 | 151 |
| 2024 Abril | 143 | 33 | 176 |
| 2024 Marzo | 206 | 30 | 236 |
| 2024 Febrero | 166 | 33 | 199 |
| 2024 Enero | 131 | 36 | 167 |
| 2023 Diciembre | 140 | 19 | 159 |
| 2023 Noviembre | 189 | 29 | 218 |
| 2023 Octubre | 181 | 35 | 216 |
| 2023 Septiembre | 128 | 36 | 164 |
| 2023 Agosto | 127 | 9 | 136 |
| 2023 Julio | 153 | 28 | 181 |
| 2023 Junio | 146 | 24 | 170 |
| 2023 Mayo | 146 | 22 | 168 |
| 2023 Abril | 201 | 22 | 223 |
| 2023 Marzo | 193 | 25 | 218 |
| 2023 Febrero | 151 | 23 | 174 |
| 2023 Enero | 135 | 25 | 160 |
| 2022 Diciembre | 140 | 52 | 192 |
| 2022 Noviembre | 86 | 29 | 115 |
| 2022 Octubre | 100 | 20 | 120 |
| 2022 Septiembre | 118 | 43 | 161 |
| 2022 Agosto | 100 | 41 | 141 |
| 2022 Julio | 84 | 27 | 111 |
| 2022 Junio | 77 | 22 | 99 |
| 2022 Mayo | 136 | 42 | 178 |
| 2022 Abril | 140 | 32 | 172 |
| 2022 Marzo | 123 | 50 | 173 |
| 2022 Febrero | 155 | 22 | 177 |
| 2022 Enero | 192 | 34 | 226 |
| 2021 Diciembre | 135 | 39 | 174 |
| 2021 Noviembre | 133 | 42 | 175 |
| 2021 Octubre | 105 | 46 | 151 |
| 2021 Septiembre | 110 | 35 | 145 |
| 2021 Agosto | 234 | 32 | 266 |
| 2021 Julio | 164 | 23 | 187 |
| 2021 Junio | 142 | 30 | 172 |
| 2021 Mayo | 178 | 33 | 211 |
| 2021 Abril | 350 | 64 | 414 |
| 2021 Marzo | 205 | 28 | 233 |
| 2021 Febrero | 152 | 32 | 184 |
| 2021 Enero | 136 | 18 | 154 |
| 2020 Diciembre | 99 | 12 | 111 |
| 2020 Noviembre | 75 | 28 | 103 |
| 2020 Octubre | 58 | 11 | 69 |
| 2020 Septiembre | 92 | 14 | 106 |
| 2020 Agosto | 41 | 24 | 65 |
| 2020 Julio | 37 | 16 | 53 |
| 2020 Junio | 53 | 22 | 75 |
| 2020 Mayo | 24 | 23 | 47 |
| 2020 Abril | 29 | 18 | 47 |
| 2020 Marzo | 36 | 18 | 54 |
| 2020 Febrero | 3 | 0 | 3 |
| 2020 Enero | 3 | 0 | 3 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 0 | 4 |
| 2019 Mayo | 4 | 0 | 4 |
| 2019 Abril | 2 | 0 | 2 |
| 2019 Marzo | 2 | 0 | 2 |
| 2018 Diciembre | 4 | 0 | 4 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Junio | 1 | 0 | 1 |
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