Protean manifestations of human papillomavirus type 60 infection on the extremities

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Abstract
Summary Background Human papillomavirus type 60 (HPV‐60) induces a ridged wart or an epidermal cyst on the sole of the foot, exhibiting identical pathological changes, with a single refractile eosinophilic intracytoplasmic inclusion body in infected cells. However, there is no information on the role of HPV‐60 in the development of cutaneous lesions on other anatomical sites. Objectives To perform the clinicopathological analysis of various cutaneous lesions of a patient in relation to HPV genotype. Patient A 50‐year‐old male patient developed multiple papules, plaques and nodules on his hand, arm and legs. Results Clinicopathologically, the lesions were classified into three categories. A common wart on the finger showed papillomatosis and acanthosis characterized by numerous keratohyalin granules. Plane warts on the arm showed perinuclear vacuolization of the cells in the upper Malpighian layer. On the other hand, a pigmented papillomatous nodule on the finger, and the other lesions on the hands and legs exhibited similar histological features with a unique cytoplasmic eosinophilic inclusion body. All the three categorized lesions were equally positive for HPV capsid antigen by immunohistochemistry. By blot hybridization analysis for HPV sequences, it was revealed that a common wart on the finger and plane warts on the arm harboured HPV‐27 and HPV‐3, respectively, while all the other lesions harboured HPV‐60. The histological localization of each viral DNA was confirmed in the corresponding lesions by in situ hybridization. Conclusions HPV‐60 is able to induce papular and nodular lesions on the extremities.