DISCUSSION
Current studies mostly describe the relationship between the treatment
of psoriasis (especially using immunomodulators and emerging biological
agents) and HPV infection. However, we considered the relationship
between chronic psoriasis and HPV activation in the presence of
anogenital warts. To the best of our knowledge, no study has discussed
HPV infection associated with other common skin manifestations besides
psoriasis.
Apart from some rare skin diseases, a high prevalence of HPV infections
is also related to the treatment of psoriasis with
psoralen-ultraviolet-A but not with tumor necrosis factor alpha
inhibitors.6,7 However, in our case, the patient had
not received any of these treatments in the past 3 years before having
anogenital warts. Carnero et al.8 reported a case of
multiple warts on psoriasis plaques and considered HPV to be involved in
the pathogenesis of psoriasis. In our case, this patient with chronic
psoriasis developed anogenital condyloma acuminata. Although they were
close to the psoriatic plaque, the warts originated from normal skin. In
the absence of a recent contact history or psoriatic therapy, we
considered that this may have been due to the activation of latent HPV
infection. Favre et al.5 described increased
permeability of psoriatic skin to viruses compared to healthy skin.
Other studies suggest that proinflammatory cytokines and the epidermal
hyperproliferation characteristic of psoriasis may be associated with
the activation of a latent HPV infection.9,10