Kirby EJ, Shereff MJ, Lewis MM: Soft-tissue tumors and tumor-like lesions of the foot: an analysis of eighty-three cases. .J Bone Joint Surg Am 71::621. ,1989. .
Fields B, Knipe D: Fields Virology, 2nd Ed, Raven Press, New York. ,1990. .
Brooks G, Butel J, Ornston L: Jawetz, Melnick, & Adelberg’s Medical Microbiology, 19th Ed, Appleton & Lange, Norfolk, CT. ,1991. .
Bunney M, Benton C, Cubie H: Viral Warts: Biology & Treatment, 2nd Ed, Oxford Medical Publications, Oxford. ,1992. .
Meberg R, Kenyon E, Bierman R, et al: Characterization of plantar verrucae among individuals with human immunodeficiency virus. .JAPMA 88::442. ,1998. .
Viac J, Chomel J, Chardonnet Y, et al: Incidence of antibodies to human papillomavirus type 1 in patients with cutaneous and mucosal papillomas. .J Med Virol 32::18. ,1990. .
Barbosa P: Plantar verrucae and HIV infection. .Clin Podiatr Med Surg 15::317. ,1998. .
Soltani S, Kenyon E, Barbosa P: Chronic and aggressive plantar verrucae in a patient with HIV. .JAPMA 86::555. ,1996. .
Kenyon E, Loveland L, Kilpatrick R, et al: Epidemiology of plantar verrucae in HIV-infected individuals. .J Acquir Immune Defic Syndr Hum Retrovirol 17::94. ,1998. .
Barbosa P, Kneass Z: Molecular biology of HIV. .Clin Podiatr Med Surg 15::189. ,1998. .
Jenkin W: “Management of Viral Infections of the Skin and Nail,” in Surgery Lecture Manual, p 14, California College of Podiatric Medicine, San Francisco. ,1994. .
Whitaker JM, Gaggero GL, Loveland L, et al: Plantar verrucae in patients with human immunodeficiency virus: clinical presentation and treatment response. .JAPMA 91::79. ,2001. .
Adler J: Pedal infectious disease associated with acquired immunodeficiency syndrome. .Clin Podiatr Med Surg 9::837. ,1992. .
Memar O, Cirelli R, Lee P, et al: Cutaneous manifestations of HIV-1 infection. .JAPMA 85::362. ,1995. .
Burns S: Podiatric manifestations of AIDS. .JAPMA 80::15. ,1990. .
Dover J, Johnson R: Cutaneous manifestations of human immunodeficiency virus infection. .Arch Dermatol 27::1383. ,1991. .
Kang S, Fitzpatrick T: Debilitating verruca vulgaris in a patient infected with the human immunodeficiency virus. .Arch Dermatol 130::294. ,1994. .
Vernon SD, Hart CE, Reeves WC, et al: The HIV-1 tat protein enhances E2-dependent human papillomavirus 16 transcription. .Virus Res 27::133. ,1993. .
Cuesta KH, Palazzo JP, Mittal KR: Detection of human papillomavirus in verrucous carcinoma from HIV-seropositive patients. .J Cutan Pathol 25::165. ,1998. .
Sun XW, Kuhn L, Ellerbrock TV, et al: Human papillomavirus infection in women infected with the human immunodeficiency virus. .N Engl J Med 337::1343. ,1997. .
Tan W, Felber BK, Zolotukhin AS, et al: Efficient expression of the human papillomavirus type 16 L1 protein in epithelial cells by using Rev and the Rev-responsive element of human immunodeficiency virus or the cis-acting transactivation element of simian retrovirus type 1. .J Virol 69::5607. ,1995. .
Ting Y, Manos MM: “Detection and Typing of Genital Human Papillomaviruses,” in PCR Protocols and Applications, p 356, Academic Press, San Diego. ,1990. .
Bernard HU, Chan SY, Manos MM, et al: Identification and assessment of known and novel human papillomaviruses by PCR amplification, restriction fragment length polymorphisms, nucleotide sequence, and phylogenetic algorithms. .J Infect Dis 170::1077. ,1994. .
Schackman BR, Gebo KA, Walensky RP, et al: The lifetime cost of current human immunodeficiency virus care in the United States. .Med Care 44::990. ,2006. .
Background: Verrucae are caused by infection of epidermal keratinocytes by human papilloma virus (HPV). Although there are currently more than 100 known types of HPV, certain lesions are consistently caused by infection with one or a few types. Recent studies have identified the presence of unusual HPV types in anogenital and cervical condylomata (warts) of patients infected with human immunodeficiency virus (HIV). Although cutaneous verrucae are typically caused by HPV-1, HPV-2, and HPV-4, infection with HIV may predispose an individual to infection with an unusual HPV type.
Methods: We report the detection of a rare HPV type in a clinically aggressive plantar verruca from an HIV-positive patient. The viral DNA from this specimen was analyzed to identify the predominant HPV type. To complete this analysis, HPV DNA was extracted from the formalin-fixed specimen, followed by polymerase chain reaction with consensus HPV primers and digestion with a specific group of restriction endonucleases. The fragments were separated on an agarose gel, and the restriction fragment length polymorphism pattern was compared with known patterns for identification of the specific HPV type.
Results: Identification of HPV-69, an HPV type previously reported to be rare and associated with dysplastic lesions, was confirmed by HPV DNA dot-blot hybridization with specific DNA probes for each known HPV type.
Conclusions: Plantar verrucae in HIV-positive patients may be associated with unusual HPV types and should be analyzed and treated aggressively given the potential for a more distinct clinical manifestation. Additional lesional analysis studies are needed. (J Am Podiatr Med Assoc 99(1): 8–12, 2009)