In summary, approximately one third of BD lesions in our Czech (Caucasian Eastern European) population are HPV-associated. In the HPV-positive lesions β- HPV genotypes predominated, although high- and low-risk mucosal HPV types were detected in a significant proportion of cases.
The presence of the p16- expression, koilocyte-like change or papillomatosis is not predictive for the presence of neither α-HPV types nor β-HPV types in extragenital/extraungual Bowen's disease. Our study further supports the hypothesis that HPV infection might serve as an important co-factor in the carcinogenesis of BD and cSCC and identifies HPV 9 as a possibly significant β-HPV genotype with respect to mixed β-HPV infections and keratinocyte carcinogenesis.