Abstract

To the Editor.— The article by Moy et al1reveals a number of risk factors for the development of squamous cell cancer of the nailbed. It was known already that at cutaneous nongenital sites, human papillomavirus (HPV) 5 produced "epidermodysplasia verucci formis" with invasive malignant features. Moy et al now report the presence of HPV 16 in six of nine patients with periungual squamous cell carcinoma. Human papillomavirus 16 has been identified previously as a cause of condylomata acuminata. Human papillomaviruses 6,11,16, and 18 have been found in the lesions of this sexually transmitted disease.2,3When found in children, these children receive close medical supervision for the development of cervical and vulvar dysplasia and cancer. Also, children with genital warts of these types generally are referred for investigation of possible child sexual abuse. We therefore are concerned about the finding of HPV 16 lesions in a nongenital site.

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