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    Paradigm shift: Link discovered between HPV, skin cancer

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    Dr. Strasswimmer
    Delray Beach, Fla. — New evidentiary links between the human papillomavirus (HPV) and skin cancer could shift the battlefront from sun avoidance to immunization, according to John Strasswimmer, M.D., of Delray Beach, Fla., a Mohs surgeon with a Ph.D. in papillomavirus molecular biology.

    "Research already shows that HPV causes many epidermal cancers.

    "It's strongly linked to at least 95 percent of cervical cancers; 70 percent of anal cancers; 50 percent of vaginal, vulvar and penile cancers; and 20 percent of oropharyngeal cancers.1

    "In dermatology, there is now strong evidence linking HPV and squamous cell carcinoma (SCC) of the fingers and nails, some epidemiology linking HPV to SCC of the skin, and a potential link between a relative of HPV and Merkel cell carcinoma," Dr. Strasswimmer says.

    More than 100 human papillomaviruses have been identified. They are numbered according to the order of their discovery. Scientists have recently subdivided the viruses into three subfamilies (alpha, beta and mu genera) based on genetic similarity.


    A patient with a history of aggressive squamous cell carcinoma demonstrated the pathologic changes of the human papillomavirus (HPV) during Mohs surgery. (Photo: John Strasswimmer, M.D.)
    According to Dr. Strasswimmer, HPV's mechanism of action is interference at the cellular level with two master switches or oncogenes, p53 and RB. High-risk human papillomaviruses — those associated with cancer — are very skillful at inactivating or altering the switches.

    In contrast, low-risk viruses — those associated with warts — are not.

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    Rebecca Bryant
    Rebecca Bryant is a medical writer based in Fayetteville, Arkansas

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