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April 2005

A Warty Masquerade—Diagnosis

Arch Dermatol. 2005;141(4):515-520. doi:10.1001/archderm.141.4.515-h

The biopsy specimen revealed “church spire” papillomatosis and acanthosis (Figure 2). There was no dyskeratosis, epidermal vacuolation, or significant inflammatory infiltrate.

A second biopsy specimen was obtained from lesional skin to detect the presence of human papillomavirus (HPV). The sample was tested by seminested polymerase chain reaction (PCR) analysis using HPV-2, B5, and NPR2 primers, which preferentially amplify HPV types associated with cutaneous lesions or epidermodysplasia verruciformis. Nested PCR analysis using MY09/MY11 and GP5+/6+ primer pairs, which is generally more useful for the detection of mucosal HPV types, was also performed. No HPV DNA was detected. The results of PCR analysis for β-globulin DNA, which was performed to assure sufficient sample quality, were positive.

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