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Published on: November 27, 2017
Myrmecia wart inclusions as an incidental histopathologic finding
Jade Wititsuwannakul1, Christine J Ko
1Department of Dermatology, Yale University School of Medicine, New Haven, CT 06520, USA. jademdcu@yahoo.com
Background:
Latent infection by human papillomavirus (HPV) has been described for genital (mucosal) and epidermodysplasia verruciformis subtypes. Only rarely has cutaneotropic, non-oncogenic HPV been found by polymerase chain reaction studies in normal skin.
Methods:
We noted myrmecia wart inclusions as an incidental histopathologic finding in four specimens from diverse sites (eyebrow, scalp, forehead, leg). The final diagnoses for these four cases were intradermal nevus, scarring alopecia, benign keratosis and stasis dermatitis. Anti-HPV antibody staining was performed in all cases. This antibody detects HPV-1,6,11,16,18 and 31 in formalin-fixed paraffin-embedded tissue.
Results:
The foci of myrmecia wart inclusions were characterized by smooth to angular cytoplasmic inclusions in the granular layer, spanning one to three rete. The inclusions stained with an anti-HPV antibody in three specimens.
Conclusions:
This finding of incidental myrmecia wart inclusions in skin biopsies supports latent infection by cutaneotropic, non-carcinogenic HPV.
Insights
Latent cutaneotropic human papillomavirus (HPV) infection is supported by incidental myrmecia wart inclusions found in diverse skin biopsy specimens. This suggests HPV may persist asymptomatically in normal skin.
Area of Science:
- Dermatology
- Virology
- Pathology
Background:
- Latent human papillomavirus (HPV) infections are known for mucosal and epidermodysplasia verruciformis types.
- Cutaneotropic, non-oncogenic HPV in normal skin is rarely detected.
Purpose of the Study:
- To investigate the presence of latent cutaneotropic HPV in normal skin.
- To identify and characterize myrmecia wart inclusions in skin biopsies.
Main Methods:
- Histopathologic examination of four skin biopsy specimens from diverse sites.
- Diagnosis of incidental myrmecia wart inclusions.
- Immunohistochemical staining using an anti-HPV antibody.
Main Results:
- Myrmecia wart inclusions observed in the granular layer of three specimens.
- Inclusions stained positive for HPV with the antibody in three out of four cases.
- Inclusions were found in biopsies with diagnoses including intradermal nevus, scarring alopecia, benign keratosis, and stasis dermatitis.
Conclusions:
- Incidental myrmecia wart inclusions in skin biopsies suggest latent cutaneotropic HPV infection.
- Supports the hypothesis that non-oncogenic HPV can remain dormant in normal skin.
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