Oncogenic Human Papillomavirus Detection in Penile Lichen Sclerosus: An Update

Aims: Aim of this study was to better address a possible association of human papillomavirus (HPV) infection with penile lichen sclerosus (LS).

Study Design: Paraffin-embedded penile biopsies obtained from adult patients with genital LS retrieved from institutional pathology files were evaluated.

Place and Duration of Study: The study has been performed in the Dermatology Clinic of the University of Catania, Italy, spanning a 19-year period.

Methodology: We previously demonstrated a high (17.4%) HPV detection rate in a study on 46 patients with genital LS. In this retrospective analysis we extended the analysis to a larger number of patients in order to strengthen these former data. HPV infection was assessed by polymerase chain reaction (PCR) in paraffin-embedded penile biopsies obtained from the glans or inner foreskin of 92 adult patients with penile LS and in brush cytology smears of penile healthy mucosa from an equal number of randomly selected control males matched for age. Statistical evaluation was performed using conditional logistic regression analysis.

Results: PCR disclosed the presence of high risk HPV infection in 22.83% of LS patients (HPV 16:16 cases; HPV 18:1 case; HPV 31:1 case; HPV 45:2 cases; HPV 68:1 case) vs 15.21% of controls, (HPV 16:4 cases; HPV 31:1 case; HPV 53:1 case; HPV 56:1 case; HPV 68:1 case; HPV 70:1 case; HPV 81:5 cases). Statistical regression analysis confirmed that the rate of oncogenic HPV infection was higher among patients with genital LS than among healthy controls (χ2=8.26; P<.01; OR=3.59).

Conclusion: These data suggest a possible pathogenetic interplay between LS and oncogenic HPV infection in the development of LS-associated penile cancer.