Human papilloma virus infection and skin cancer in renal allograft recipients.

Abstract 202 renal allograft recipients in south-east Scotland, who had received transplants between 1965 and 1986, were monitored over 3 years (1984-87) for the presence of warts, keratoses, and skin cancers. 77% of 69 patients with graft survival of more than 5 years had viral warts, 38% had keratoses, and 12% had skin cancers, whereas of the 133 with graft survival of less than 5 years 20% had warts, 17% had keratoses, and 1·5% had skin cancers. The ratio of squamous cell carcinoma to basal cell carcinoma was 15:1. Most viral warts showed significant epidermal dysplasia, and keratoses and squamous cell carcinomas had signs of human papilloma virus infection. 15 (60%) of 25 squamous cell carcinomas contained HPV5/8 DNA and 1 contained HPV4 DNA— HPV5/8 DNA was detected in skin lesions of recipients with cancers significantly more often than in those matched for duration and type of immunosuppression with non-malignant skin lesions. The findings suggest a role for HPV5/8 in the aetiology of squamous cell carcinoma in renal allograft recipients.