The cause of
epidermodysplasia verruciformis is
infection by human papillomavirus, usually types 5 or 8, and it exhibits a high potential for malignant transformation. The diagnostic histologic features of
epidermodysplasia verruciformis are not always present and can be mimicked by non-
viral diseases. The purpose of this study was to interrogate such lesions for new potential
biomarkers to aid in the diagnostic accuracy. HPV
DNA was high copy and localized to the upper half of the lesion in cells with cytologic features that included perinuclear halos, blue-grey cytoplasm, and hyper/
parakeratosis. Serial section analyses demonstrated that there was increased expression of
importin-β, exportin-5, Mcl1, p16, Ki67 and PDL1 in 13/13
epidermodysplasia verruciformis lesions. Each of these
proteins localized primarily to the less differentiated cells in the parabasal aspect of the lesion. Only Ki67 and exportin-5 were expressed in the normal epithelia, though much less so, in 13/13 aged matched controls. It is concluded that the host response to HPV 5/8
infection in
epidermodysplasia verruciformis includes the up regulation of several
proteins including p16, Ki67,
importin-β, exportin-5, Mcl1, and PDL1. Thus, these
proteins may serve as new
biomarkers of this disease that can aid in cases that are equivocal for
epidermodysplasia verruciformis on histologic examination.