Immunohistochemical Evaluation of Angiogenesis in Warts

Background: Angiogenesis is a key event in tumour growth. An infection with human papillomavirus (HPV) typically leads to benign tumours, such as warts (papillomas) on the skin and mucous membranes. The role of angiogenesis in skin warts is yet to be established. The present work evaluates the hypothesis that the development of skin warts is associated with alterations in the dermal vascularisation (dermal microvessel density/mm 2 , MVD). Methods Seventeen cases of cutaneous warts and eight cases of normal skin were studied. Dermal vessels were immunostained for CD31, CD34 and CD105. The ten areas with the highest number of microvessels were counted. Results The number of CD31 + , CD34 + and CD105 + vessels was significantly higher in cutaneous warts compared to that in normal skin (mean±SD: 45.71±22.63 vs 21.27±5.83, P=0.0062; 59.75±24.93 vs 17.13±5.67, P<0.001; and 29.74±7.09 vs 6.58±1.89, P<0.001 respectively). Conclusion Higher MVD values in skin warts suggest a possible causal correlation between angiogenesis and development of papillomas in HPV infected skin. Our results shows the morphological histopathological explanation (high number of vessels) for the punk-shaped vessels seen in the dermatoscopical examination.