Human papillomavirus in venous ulcers with and without squamous cell carcinoma

Malignant transformation of chronic wounds is a well-known, albeit rare, phenomenon. We examined archival paraffin blocks of samples of squamous cell carcinoma (SCC) in chronic venous leg ulcers previously taken from 23 patients and of chronic noncancerous venous leg ulcers from 35 patients for the presence of human papillomavirus (HPV) DNA. The methods used were the polymerase chain reaction (PCR) with GP05+/06+ (mucosal) and nested PCR with CP65/70 and CP66/69 (EV-associated) primers. A subsequent nonradioactive Southern blot hybridization was used to confirm the specificity of the PCR. With PCR three samples were positive on the gel, and with Southern blotting, a further seven samples were positive, to give a total of ten samples. All of the positive samples were from the noncancerous ulcers and with the primers GP05+/06+. HPV infection is probably not the carcinogen responsible for the malignant transformation of venous leg ulcers. The difference in positivity between the ulcers and the SCCs was statistically significant (P = 0.01) and raises the question as to whether HPV-positive cells are eliminated in the interaction between the SCC and the immune system. Further studies on the carcinogenic effects of chronic proliferation and the role of HPV infection therein, are needed.