Studies On Genotypes Of Human Papillomaviruses And Clinical Fatures In Special Warts

In dermatology clinical work,we encountered patients with warts in between toes,in armpits,on the groin,cauliflower-like warts on head and face;papule-like warts in genital site.These cauliflower-like lesions were similar to condylomata acuminata and papule-like lesions were similar to verruca vulgaris in morphology.What was the exact diagnosis with these special warts? Was there any high-risk genotypes in these warts?—We have studies on these special warts to expore basic molecular epidemiological and the clinical and histological characteristics to help dermatologist answer the stumbles in clinic.The paper consists of three parts.Part 1 The distribution of the HPV genotype of human papillomavirus(HPV) infections among patients within special warts.Objectives To investigate the molecular epidemiological characteristics of human papillomavirus(HPV) infections among patients with special warts (warts in webspace or groin;cauliflower-like warts on head and face; papule-like warts in genital site),analyze the distribution of the HPV genotype.Methods DNA isolated from warts specimens were amplified by PCR and sequencing to identify HPV genotype.Type-special primer PCR(TSP-PCR) of HPV2,4,6,7,11,16,and 18 were also performed to compare the conformity of the two methods.Results(1) Ninety-five cases were enrolled in the study groups.The main genotype was HPV7 in interdigital group(20 cases) and groin group(29 cases).In head and face group(30 cases),HPV7 and HPV27 were the main genotype.HPV6 and HPV11 were the main genotypes in genital group(18 cases). HPV2,7,27,57 were the main genotypes in verruca vulgaris group(31 cases). And a high-risk genotype(HPV16) was detected in genital and groin group. There was significant difference between some groups and the verruca vulgaris control group in constituent ratio of HPV7(interdigital group P=0.000,groin group P=0.000,genital group P=0.011).There was no significant difference between head and face group and verruca vulgaris group in constituent ratio of HPV 7(P=0.413).(2)The results of 7 pairs TSP-PCR showed that a variety of mixed-genotypes infection existed in all groups.The conincidence rates were 80-99%in sequencing and TSP-PCR.Conclusions Warts located in webspace and groins are prone to be caused by HPV7.HPV7 and HPV27 are the main genotype in cauliflower-like warts on head and face.HPV6 and HPV11 the main genotypes in papule-like in genital warts.High risk HPV(HPV16) genetype DNA exists in genital and groin warts.Part 2 Clinical and histological features and the potential relationship between HPV genotypes and clinical characteristics in patients with these special warts.Objectives To expore the clinical and histological features and the potential relationship between HPV genotypes and clinical characteristics in patients with these special warts.Methods The clinical and histological characteristics of those warts,the relationship between HPV genotypes and its clinical and histological characteristics were analyzed and statisticsed by SPSS.Results The patients were all males,warts were mainly cauliflower-like and papule-like in interdigital group and groin group.There was significant difference between these two groups and the verruca vulgaris control group in gentile(P=0.000) and morphous(cauliflower-like,P=0.011;papule-like P=0.005).But there was no significant relationship between the morphology of the warts and HPV genotype.Fifty-six specimens were taken for analysis of histopathological patterns.It revealed 18 cases showing verruca vulgaris-like pathology patterns,16 condyloma accuminatum-like pathology features,and 22 cases could not determine verruca vulgaris-like or condyloma accuminatum-like pathology patterns.Main HPV7(9/18) positive samples' pathology manifestations matched the characteristics for HPV7 infection,which showed papillomatosis and acanthosis,deep-stained cells including keratohyalin granules in middle size,and obvious hyperkeratosis and parakertosis.Conclusions Warts located in webspace and groins,mainly cauliflower-like and papule-like,are prone to offend male patients.But there is no significant relationship between the morphology and HPV type of the warts. Special warts could show verruca vulgaris-like or condyloma accuminatum-like pathology patterns.Part 3 TA clone of PCR products and detection of the HPV DNA in scales of webspace.Objectives To explore the role of HPV7 in the pathopoiesis of warts. Methods the gene sequence of HPV found in webspace specimens was studied with PCR and TA clone.The HPV and HPV7 DNA in scales of webspace in patients with tinea pedis and healthy persons were both detected by nest-PCR and TSP-PCR.Results The purified and amplified DNA of 12 specimens in interdigital group were cloned with the pUC57-T Vector Cloning Kit.Four recombinant plasmids harboring inserts of the expected size were randomly selected and sequenced. The result showed the sequence shared 90%or more homology to the HPV genotype in direct sequencing.HPV DNA was detected in scales specimen of the webspace in 53 patients with tinea pedis and 48 healthy persons.HPV DNA positivity rate was 5/53 and 5/48 respectively in nest PCR.There was no HPV7 positive in all scale specimens in TSP-PCR.The results revealed statistically significant difference in sex ratio(P=0.002),and the positivity rate of HPV(P=0.000) or HPV7(P=0.000) between interdigital and tinea pedis groups or between interdigital and healthy person groups.There was no significant difference between the tinea pedis group and healthy persons group in sex ratio(P=0.835) or positivity rate in HPV7(P=0.829).Conclusions HPV7 maybe plays a pathogenic role in the development of interdigital warts.It could induce warts in immunocompetent patients.