Myrmecia wart inclusions as an incidental histopathologic finding

Abstract

Latent infection by human papillomavirus (HPV) has been described for genital (mucosal) and epidermodysplasia verruciformis subtypes. Only rarely has cutaneotropic, non-oncogenic HPV been found by polymerase chain reaction studies in normal skin. We noted myrmecia wart inclusions as an incidental histopathologic finding in four specimens from diverse sites (eyebrow, scalp, forehead, leg). The final diagnoses for these four cases were intradermal nevus, scarring alopecia, benign keratosis and stasis dermatitis. Anti-HPV antibody staining was performed in all cases. This antibody detects HPV-1,6,11,16,18 and 31 in formalin-fixed paraffin-embedded tissue. The foci of myrmecia wart inclusions were characterized by smooth to angular cytoplasmic inclusions in the granular layer, spanning one to three rete. The inclusions stained with an anti-HPV antibody in three specimens. This finding of incidental myrmecia wart inclusions in skin biopsies supports latent infection by cutaneotropic, non-carcinogenic HPV.