Analysis of human beta papillomavirus and Merkel cell polyomavirus infection in skin lesions and eyebrow hair bulbs from a cohort of chronic lymphocytic leukaemia patients.

BACKGROUND: Research consistently demonstrates an increased incidence of skin cancer in the immunocompromised host, including patients with chronic lymphocytic leukaemia (CLL) and organ transplant recipients (OTRs). Active human beta papillomavirus (β-HPV) infection has been found in OTR skin lesions, suggesting their possible involvement in skin carcinogenesis. Although less frequent, Merkel cell polyomavirus (MCPyV) has also been reported in cases of skin cancer. OBJECTIVES: To investigate: i) potential correlations between patient clinical features and skin cancer development; and ii) the presence of β-HPV and MCPyV DNA and protein markers in skin lesions and hair bulbs from CLL patients. METHODS: The clinical features of 293 patients with CLL were analysed according to the presence or absence of skin lesions. β-HPV and MCPyV infection was investigated in skin lesions and hair bulbs from the study cohort by both PCR analysis and immunohistochemical screening. RESULTS: No significant correlations were observed between any of the analysed haematological parameters and the development of skin cancer. PCR analysis revealed the presence of β-HPV and MCPyV DNA in skin lesions, and 83% of positivity for MCPyV DNA in hair bulbs, while systematic immunohistochemical analysis of all the lesions failed to detect any expression of the viral proteins β-HPV E4, L1 or MCPyV LTAg. CONCLUSIONS: Overall, our data indicate that carriage of β-HPV and MCPyV in the lesional skin and hair bulbs from CLL patients without any evident reactivation at skin tumour sites most likely represents coincidental rather than causal infection. This contrasts with our previous findings in relation to OTR-derived skin lesions.