Abstract:

【Abstract】 Objective  To investigate the clinic and pathologic manifestation of Hyperkeratosis of the nipple and areola (HNA) and explore the relationship between HNA and the HPV infection, which may provide a theoretical basis for determine the etiology, pathogenesis and incentives of this disease.  Methods  Fourteen formalin-fixed, paraffin-embedded skin biopsy specimens with pathological confirmed HNA were tested for HPV DNA by short PCR fragment(SPF) of the general primers of HPV using polymerse chain reaction(PCR) amplification technology. The expression of HPV were detected by immunohistochemistry in theses species (Envision system). The clinical and pathological features of HNA were studied as well.  Results  1. All of the 14 patients showed verrucous hyperplasia and hyperpigmentation in their skin lesions, of which 6 involved the nipple, 6 involved the areola and 2 involved both. Unilateral of the nipple and (or) areola was involed in 8 cases and bilateral in 6 cases. Five patients had itching while 7 patients were asymptomatic. 2. As to the pathological changes of the dermis, all of the 14 patients are similar. The pathological changes of HNA mainly involved the epidermis: five of 14 (35.71%) showed hyperkeratosis and acanthosis, 10 of 14 (71.43%) showed papillary hyperplasia, and 6 of 14 (42.86%) found the koilocytes or vacuole-like cells. 3. Thirteen out of 14 formalin-fixed, paraffin-embedded specimens showed HPV positive by PCR primers SPF and 8 of 14 showed HPV positive by immunohistochemestry (EnVision system).  Conclusion  1. The common feature of clinicalpathological manifestations of HNA: verrucous hyperkeratosis and dark brown hyperpigmentation of the nipple and (or) areola, hyperkeratosis, acanthosis, papillary hyperplasia and vacuole-like cells can be found in the epidermis. 2. Hyperkeratosis of the nipple and areola (HNA) may be relative to the infection of HPV.

Key words: Human papilloma virus