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Association With Perianal Carcinoma In Situ and Condyloma Acuminatum

Brian R. Bradshaw, MD; Gerard J. Nuovo, MD; Damian DiCostanzo, MD; Steven R. Cohen, MD

Arch Dermatol. 1992;128(7):949-952.

Abstract
• Background.—
The association of anal carcinoma with human papillomavirus (HPV) type 16 infection is well documented. Anal carcinoma is also frequently associated with a history of anogenital condylomata. More than 90% of anogenital condylomata contain HPV type 6 or 11. It is rare for a condylomatous lesion to contain HPV 16. We report the unusual case of a homosexual man, testing positively for human immunodeficiency virus, with carcinoma in situ evolving within perianal condylomata infected with HPV 16.

Observations.—
Microscopic examination of tissue specimens from ulcerated verrucous lesions on the perianal mucosa revealed changes of classic condylomata acuminata with contiguous focal squamous cell carcinoma in situ. Testing for HPV DNA by in situ hybridization identified HPV 16 in both the condylomatous and carcinoma in situ areas.

Conclusions.—
The association of HPV 16—infected condylomata and adjacent carcinoma in situ implies that cutaneous genital condylomata may progress to high-grade lesions. Given that homosexual men are at high risk for perianal carcinomas, HPV typing of perianal condylomata specimens may help identify immunocompromised patients who are at risk for the development of carcinomas.

(Arch Dermatol. 1992;128:949-952)

Author Affiliations
From the Departments of Dermatology, Beth Israel Medical Center and Mount Sinai Medical Center, New York, NY (Drs Bradshaw, DiCostanzo, and Cohen), and Departments of Pathology, State University of New York, Stony Brook, NY (Dr Nuovo) and Beth Israel Medical Center, New York, NY (Dr DiCostanzo).

Footnotes
Accepted for publication February 4, 1992.

Reprint requests to Department of Dermatology, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003 (Dr Cohen).

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