Información del artículo
Abstract
The relationship between mucosal human papillomavirus (HPV) and cervical carcinoma or anogenital squamous cell carcinoma (SCC) is becoming increasingly evident, whereas a link between HPV and other cutaneous SCCs is less clear. Recent studies have reported links between epidermodysplasia-verruciformisassociated HPV and extragenital cutaneous SCC, particularly in immunosuppressed patients, although immunocompetent patients have also been affected. Mucosal HPV could also be linked to some types of Bowen disease and certain SCCs of the fingers, oropharyngeal mucosa, etc. We review the possible oncogenic mechanisms involving mucosal HPV and epidermodysplasia-verruciformis-associated HPV. Most SCCs could be explained by the combined action of HPV, immunosuppression, and the oncogenic and immunosuppressive effect of UV radiation. HPV might be associated with worse prognosis of SCC, with implications for clinical practice including greater risk of metastasis.
Key words:
human papillomavirus
HPV
epidermodysplasia verruciformis
squamous cell carcinoma
skin
Resumen
La relación entre los virus papilomas humanos (VPH) de tipo mucoso (VPH-muc) y el carcinoma de cérvix o los carcinomas espinocelulares (CE) de la región ano-genital es cada vez más evidente. Sin embargo, la relación del VPH con el resto de los CE cutáneos es más controvertida. Recientes publicaciones relacionan los VPH tipo epidermodisplasia verruciforme (VPH-EV) con los CE cutáneos extra-genitales, sobre todo en los pacientes inmunodeprimidos, aunque también en los inmunocompetentes. Los VPH-muc también se podrían relacionar con algunas enfermedades de Bowen y determinados CE: dedos de manos, mucosa oro-faríngea, etc.
Revisamos los posibles mecanismos oncogénicos de los VPH-muc y los VPH-EV. La mayoría de los CE podrían explicarse por la acción conjunta de los VPH, la inmunodepresión y los efectos oncogénicos e inmunosupresores de las radiaciones ultravioleta. Los VPH podrían implicar un peor pronóstico de los CE, con más posibilidades de producir metástasis, entre otras implicaciones en la práctica clínica.
Palabras clave:
virus papiloma humano (VPH)
epidermodisplasia verruciforme
carcinoma espinocelular
piel
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