Does Herpes simplex virus (HSV) cause BCC?

A staff member at the Tasman Medical Journal recounts having a solar-activated cold sore (presumed HSV infection) at the same site on the forehead over many years.  One year the lesion returned in spring as usual but its evolution differed from previous years. The herpetic crusting resolved but a patch of erythema remained at the site.  It was eventually biopsied and was shown to be a basal cell carcinoma which was resected.  The solar keratosis has not returned since, over a period of about 30 years.

Viruses including HSV cause or are strongly associated with a variety of human cancers (see table):

VirusRecognised Tumour Sites
HSVCervix, vulva
Human papilloma virus (HPV)Skin (papilloma), cervix, penis, anus, vagina, vulva, mouth, throat
Epstein-Barr virus (EBV)Nasopharynx, lymph, stomach
Hepatitis B and CLiver
Human immunodeficiency virus (HIV)Skin, GI tract (Kaposi sarcoma), cervix, anus, lung, liver
Herpes virus 8 (Kaposi sarcoma-associated herpes virus)Skin, GI tract (Kaposi sarcoma)
Human T-lymphotropic virus-1Blood (T-cell leukemia)
Merkel cell polyomavirus (MCV)Skin (Merkel cell carcinoma)

Efforts have been made to detect viral DNA in non-melanotic skin cancers using polymerase chain reaction (PCR) methodology.  Zaravinos and colleagues studied the presence of HPV, cytomegalovirus (CMV), HSV and EBV in 53 biopsy samples collected from immunocompetent patients.  The incidence of each viral species was:

HPV: 8 of 26 (31%) in actinic keratosis (AK);  CMV: 12 of 53 (23%);  6 of 15 (40%) in BCC specimens; 2 of 26 (8%) in AK and 4 of 12 (33%) in squamous cell carcinoma (SCC).  No normal skin biopsy was found to be positive for CMV. All cutaneous samples were negative for HSV and EBV DNA, as assessed by our PCR-based assays. One AK (4%), one basal cell carcinoma (BCC) (6%) and one SCC (8%), were found to carry a G>T transversion at the second position of HRAS codon 12.

Thus the scientific evidence that HSV causes BCC is weak.  Our staff member was obviously unlucky!

Reference

Zaravinos A, Kanellou P, Spandidos DA.  Viral DNA detection and RAS mutations in actinic keratosis and nonmelanoma skin cancers.  Br J Dermatol 2010; 162: 325-31.  DOI: 10.1111/j.1365-2133.2009.09480.x

COMMENTS

Leave a Reply

Your email address will not be published.

SHARE POST

Journal Subscription

Receive the latest Tasman Medical Journal articles as they are published.  Journal subscription is free. 

MORE POSTS

Accuracy of coded cause of death data: a study based on primary liver cancer

We have investigated the level of agreement for cause of death data in 232 patients who died of primary liver cancer, based on National (Australia Bureau of Statistics) and State (Tasmanian Cancer Registry) data and independent medical practitioners. The agreement between the ABS and TCR was poor but between medical practitioners was strong, and intermediate for comparisons between practitioners and either agency. Overall, cause-specific survival time was similar across the TCR, ABS and medical practitioners; with a small difference observed regarding the type of liver cancer. As liver cancer is a low-survival cancer, such results may be different to cancers with better survival such as breast cancer. Utilisation of specialist clinician oversight might improve data cohesion and fidelity.

Read More »

Test Pop-up