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