Cases reported "Warts"

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1/25. Oral wart associated with human papillomavirus type 2.

    More than 100 human papillomavirus (HPV) types have been identified to date. Of these, 24 types have been described as being associated with oral lesions. HPV-2 has been frequently associated with skin lesions, but the reports of oral lesions as features of mucosal infection are limited. A biopsy specimen of an oral wart on the right palate was taken from a 48-year-old man and examined for the presence of HPV The sections showed papillary growth of the epithelium with hyperkeratosis and parakeratosis, and koilocytotic changes of the cells located in the upper layers of the oral squamous cell epithelium. These histological features corresponded well to those of verruca vulgaris on the skin. Immunohistochemically, papillomavirus genus-specific capsid antigen was detected in most of the koilocytotic cells. In addition, Southern blot hybridization analysis revealed that the lesion harbored HPV-2 dna. in situ hybridization with a biotinylated HPV-2 dna probe clearly demonstrated viral dna in the nuclei of squamous cells, which were located in a deeper layer of the epithelium than viral antigen-positive cells.
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2/25. Prominent hyperkeratotic plantar and palmar warts.

    We report the case of a 28-year-old man who had prominent hyperkeratotic plantar and palmar warts, and flat warts on his face and chest. By dna hybridization, human papillomavirus 1 and/or 2, and 3 dna were detected from the tissues of these skin lesions. Results of laboratory investigations revealed leukopenia, eosinophilia, anti-HBs antigen and anti-hepatitis c virus antibody, and decrease in the OKT4/OKT8 ratio. He had no abnormality in cellular immunity. He was treated with multiple modalities, but was successfully treated with electrocautery to the plantar and palmar warts, and cryotherapy with liquid nitrogen to the flat warts. Nine years after the initial treatment, almost no recurrence was recognized.
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3/25. A solitary cutaneous tumor with distinct areas of verruca and seborrheic keratosis-like lesion.

    A single, exophytic, cutaneous tumor on the thigh of a 52-year-old man was examined by light microscopy, in situ hybridization and immunohistochemistry. It demonstrated distinct areas of verruca and of seborrheic keratosis-like morphology simultaneously. Focally, architectural abnormalities were noted in some deeper parts of the tumor, but there was no morphological evidence of malignancy. The patient has remained disease-free for two and a half years after surgery. Biotinylated full genomicDNA probes of HPV confirmed the presence of types 6/11 exclusively in the verrucous portion of the neoplasm. In the verrucous component p53 protein was overexpressed and, additionally, increased Ki-67 immunopositive signals were detected, being localized below the HPV-dna-expressing spinous cells.
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keywords = hybridization
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4/25. A case of viral warts with particular fibrillar intracytoplasmic inclusion bodies.

    A new type of skin wart was observed in a Japanese patient. It was characterized by intracytoplasmic inclusions with a 'fibrillar' structure which were distinct from previously described wart-associated inclusions. The papillomavirus (HPV)-group-specific antigen could be detected, but dna hybridization and PCR amplification using probes or PCR primers specific for the main skin HPV genotypes (including HPV-63 which is also associated with 'filamentous' inclusions) were negative. We consider that this cytopathic effect could correspond to an HPV genotype which has not yet been characterized.
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keywords = hybridization
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5/25. Extensive human papillomavirus type 7-associated orofacial warts in an immunocompetent patient.

    Human papillomavirus (HPV) type 7 is frequently found in butchers' warts and has been demonstrated in oral and facial warts of hiv-infected patients. The reservoirs of HPV7 and the route of transmission are still unclear. Here we describe an hiv-negative, otherwise healthy patient with extensive, recurrent orofacial papillomatosis whose immune status proved to be normal and who had no history of meat handling. HPV7 L1 gene dna that differed in 3 point mutations from the HPV7 prototype could be detected in 2 morphologically distinct, perioral lesions by different PCR protocols. in situ hybridization confirmed the presence of HPV7 dna in the nuclei of vacuolated cells of the granular layer. Our data show that HPV7 can lead to perioral, spiky warts and brownish plaques in immunocompetent patients who had never been working as a meat or fish handler.
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6/25. Human papillomavirus associated bowen's disease of the foot: unique clinical features mimicking a common wart.

    We describe a case of bowen's disease that developed on the left dorsal foot of a 56-year-old female patient and that mimicked the clinical features of a common wart. PCR-based analysis indicated that the lesion contained HPV-16 dna and HPV-16 positive cells were found in the upper layers of the epidermal lesion using in situ hybridization with an HPV-16 probe.
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7/25. Characteristic intracytoplasmic material in a perianal wart that contains human papillomavirus type 56 and 16 dna.

    We report the case of a perianal wart in which human papillomavirus type 56 and 16 DNAs were detected, arising in a 29-year-old healthy Japanese female. Clinically, moist erythema and small flat pinkish papules appeared around the anus and worsened over a period of 6 months. Histopathologically, no signs of dysplasia or atypia were apparent. An area of intracytoplasmic material, which was homogeneous and eosinophilic, was contained in each epidermal cell. The wart showed HPV-56 and HPV-16 DNAs by PCR and reverse-phase dot blot hybridization. Additional Southern blot analysis showed the amount of HPV-56 dna to be more than 10 times that of HPV-16 dna. This is the first case, to our knowledge, of a perianal wart with intracytoplasmic material, which contains HPV DNAs causing mucous lesions.
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8/25. Protean manifestations of human papillomavirus type 60 infection on the extremities.

    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.
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9/25. Detection of human papillomavirus type 57 in the tissue of a plantar epidermoid cyst.

    Plantar epidermoid cysts with human papillomavirus (HPV) infection are not rare in japan. Most of them show the cytopathic effect of HPV type 60 - homogeneous intracytoplasmic inclusion bodies. Our case presented a plantar epidermoid cyst with vacuolation around the granular cell layer without any features of HPV type 60. in situ hybridization and polymerase chain reaction followed by dna sequencing analysis revealed an association with HPV type 57.
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keywords = hybridization
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10/25. Verruciform xanthoma of the ear with coexisting epidermal dysplasia.

    We report a case of verruciform xanthoma of the ear in a 79-year-old man. The case is unique in that it contained an area of solar keratosis. in situ hybridization using biotin-labeled probe cocktails for human papillomavirus types 6/11, 16/18, and 31/33/35 yielded negative results.
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keywords = hybridization
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