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Stratum corneum RNA levels are diagnostic for melanoma
Author(s) -
Grichnik J.M.
Publication year - 2011
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2011.10283.x
Subject(s) - miami , stratum corneum , dermatology , medicine , library science , pathology , computer science , environmental science , soil science
For many years, a search for a viral trigger or cofactor for psoriasis has failed to give any clear pathogenetic lead. Among the candidates for disease-influencing infectious agents are the cutaneous papillomaviruses, especially the betapapillomaviruses, the genotypes originally described in epidermodysplasia verruciformis. They are found commonly in the skin and skin cancers of the immunosuppressed and are not uncommon in normal individuals. With the ability to remain latent or as subclinical commensals on the skin, but with known epidermal proliferative effects, this virus group fulfils some of the possible requirements to influence development of psoriasis lesions on the skin. It is over a decade since the first report suggested a possible link between psoriasis and papillomavirus infection, when both anti-papillomavirus antibodies and human papillomavirus (HPV) detection in patients with psoriasis were found to be higher than in normal individuals and patients with atopic dermatitis. de Koning et al., in this issue, compare patients with psoriasis and with atopic dermatitis, using both the detection of betapapillomavirus DNA in eyebrow hair bulbs and the level of antibodies to the viral capsid coat protein, the L1 protein, in 15 b-HPVs. The authors report b-HPV detection in 100% of 27 patients with psoriasis compared with 81% in 17 patients with atopic dermatitis. These viruses can be detected in up to 90% of normal individuals, so the atopics would be within the normal range. Antibodies to the b-HPVs, however, were more common in patients with atopic dermatitis (88%) compared with patients with psoriasis (56%). Some larger, more detailed studies have suggested that antibodies to b-HPVs may increase with age in the general population, but the prevalence of a large range of antibodies in a group of relatively young patients with atopic dermatitis (mean age 40 years) is higher than expected. It could be speculated that the immune response is helping to control the virus carriage or the effects of its presence, but as antibodies to HPV are not known to clear infection it is unlikely that they could play an active role in removal of established HPV presence. This study does not confirm a pathogenetic role for HPV in psoriasis, but it does add further support to the published data suggesting that b-HPVs are readily detectable in psoriasis and that this may not just be due to inflammation and poor barrier function of the skin. There is no universal agreement that patients with psoriasis harbour a larger number of HPV types than normals, but the results here corroborate this previously reported finding. There is quite some way to go before we will really know if and how psoriasis is influenced by these papillomaviruses.