Detection of HPV-20, HPV-23, and HPV-DL332 in a solitary eyelid syringoma.

PURPOSE: To report evidence of many human papillomavirus types occurring in a solitary syringoma clinically appearing as a papilloma. METHODS: A 57-year-old man presented with a 10-year history of an upper eyelid tumor. Histopathology, human papillomavirus-nested polymerase chain reaction, human papillomavirus-DNA cloning into vector pCR2.1, sequencing, and computer-assisted evaluation were performed. RESULTS: Histopathology demonstrated a solitary benign syringoma. HPV-20 and HPV-23 were present in one clone each, and HPV-5-related HPV-DL332 was present in 9 clones. CONCLUSION: Many human papillomavirus types may be detected in an ocular syringoma.

[Detection of human papillomavirus types in tumors and inflammations of the eye]. / Nachweis humaner Papillomavirustypen bei Tumoren und Entzündungen am Auge.

BACKGROUND: Infections by the human papillomavirus occur in the skin and in the mucosa. They may play a significant role in the neoplastic transformation of cells. At least half of all the epithelial tumours of the ocular surface and the lacrimal drainage system have been shown to be HPV associated. However, in ca. 50% of these tumors only a limited number of mucosal HPV types could be detected by commercially available test systems. This study reports of HPV specific sequences in putatively HPV associated tumorous and inflamed tissues of the eye. MATERIALS AND METHODS: 32 biopsies of 26 patients suffering from chronic hyperplastic lesions of the lid, conjunctiva and lacrimal drainage system were examined using DNA extraction, amplification of HPV specific sequences by nested polymerase chain reaction (PCR), cloning and sequencing of the PCR products. RESULTS: Ten HPV types could be detected in 11 biopsies of 8 patients with papillo-mas, seborrheic and actinic keratosis, dacryocystitis and syringoma. In 5 of 9 histologically verified papillomas HPV 6, 20, 23, DL 332 (HPV 5b-related), DL 284 (HPV 20-related) and NN-AA44 were detected, HPV 5b, 38 and DL 284 in seborrheic keratoses, HPV 36 in actinic keratosis, NN-AA44 und NN-AA45 in dacryocystitis and HPV 20, 23 and DL 332 in syringoma. CONCLUSIONS: The DNA techniques used in this study represent important methods for the detection of HPV types and allow an association of HPV types with defined tumours and inflammations of the eye. In two of the biopsies putatively new HPV types could be identified.

[Therapy refractory unilateral chronic blepharokeratoconjunctivitis as the chief manifestation of auto-aggression syndrome. Clinico-histopathologic findings]. / Therapieresistente einseitige chronische Blepharokeratokonjunktivitis als Leitbefund für Autoaggressionssyndrome. Klinisch-histopathologische Befunde.

UNLABELLED: Autoaggressive syndromes as causes of diseases underlying chronic blepharitis and keratoconjunctivitis that are refractory to treatment are often difficult to recognize. PATIENTS: Three female patients (age 21, 25, 41 years) and one male patient (age 42 years) had suffered from a right-(4x) or left-(1x) handed treatment-refractory blepharokeratoconjunctivitis for 1, 2, 11 and 30 months prior to admission. In each case more than 5 ophthalmologists and 2-6 eye hospitals had been consulted, and extraocular surgery had been performed 1-4 times. RESULTS: Patients presented with a visual acuity of 0.3 p (1x), 0.1 (1x), FC (1x), HM (1x). In three patients contact eczema of the facial skin and lids and a corneal pannus were observed; in two patients we saw purulent pseudomembranous and in two patients chronic cicatrizing keratoconjunctivitis. Conjunctival smears grew P. aeruginosa, and S. aureus; impression cytology showed infiltration with neutrophils and epithelial keratinization; histopathology indicated chronic inflammatory, partly purulent subepithelial and stromal conjunctival infiltrate with hyper- and parakeratosis fibrous strands and epithelial cell loss; the lower lids showed parakeratosis, focal necrosis, intercellular edema and a lymphohistiocytic round-cell infiltrate. Furthermore, multiple allergies to antibiotics and preservatives (4x), lacerations of the arms and legs (2x) and an irritative-toxic dermatitis (1x) were substantiated. In the patients who agreed to a psychiatric consultation, somatized-agitated longing for care combined with a dependent and infantile personality (1x) and reactive depression (2x) were verified. CONCLUSIONS: In patients suffering from treatment-refractory unilateral chronic blepharokeratoconjunctivitis correlated with the hand, one must take into consideration the fact that other factors may be involved: possible exacerbation prior to examinations; multiple inpatient diagnostic and surgical procedures in different locations; histopathological mixed inflammatory patterns; and psychiatric syndromes.