Background: Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by disseminated infection caused by specific types of human papillomavirus (HPV) that may cause malignant tumors and immunological disturbances. There is increasing evidence that dysfunction in cell-mediated immunity is a causative factor in EV; however, the specific immune defect has not been fully elucidated. 

Objectives: To study the clinical and immunohistochemical features of one case of EV aiming to contribute to knowledge of disease.

Material and Methods: DNA was isolated from the skin lesion of a 45 year old white woman, showing disseminated verrucous lesions and HPV DNA was amplified through PCR using primers MY09/MY11 and GP5+/GP6+. The amplicons were sequenced using the DNA Sequencing Plataform (PDTIS-FIOCRUZ)., The sequences were edited, aligned and submitted for phylogenetic analysis in order to characterize the HPV type using the software MEGA 4.0. By means of immunohistochemistry monoclonal antibodies to p53, TOPO-2, MCM-2, CD8, CD68, Ki-67, CD45Ro and ICAM-1 were used to analyze the immune and tumor profile.

Results: The common HPV type-2 as isolated from the lesion, where we also observed a high expression of bio-markers related to tumor as TOPO-2 (93%), MCM-2 (80%), p53 (98%). Immunohistochemical examination disclosed few CD8T cells, a high number of macrophages CD68 positive (89%) and no memory cells (CD45 Ro); adhesion molecule, detected by ICAM-1 (18%) stained weakly.

Conclusions: The HPV2 found, inducing common warts, may however have a relationship between the high expression of tumor markers type of HPV and the clinical picture of EV. Additional studies with others immune markers will be done to elucidate the clinical outcome.

Support: FAPERJ; IOC-Fiocruz - RJ, Brazil