Human papillomavirus type 6/11 identified in an epidermoid cyst of the scrotum

To date, epidermoid cysts associated with human papillomavirus (HPV) infection have been described mainly in palmoplantar locations, and have involved HPV types 60 and 57. In contrast, HPV-6/11 is a major cause of condyloma acuminatum. Here, we report the case of a healthy 31-year-old man who presented to our clinic with a 1-month history of a 1-cm, reddish-brown, cystic scrotal tumor with a punctum. The lesion was studied histologically, immunohistochemically and by DNA-DNAin situ hybridization. Histology revealed an epidermoid cyst with vacuolated keratinocytes with shrunken nuclei (koilocytes) in the cyst wall. Immunostaining was positive for HPV antigens and in situ hybridization revealed HPV-6/11 DNA in the koilocytes. This is the first report of an HPV-6/11-associated epidermoid cyst in the anogenital skin of an immunocompetent individual.