الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Skin tags (STs), or acrochordons are considered the most common fibrous lesions of the skin. STs are small, soft, usually pedunculated benign skin growths, mostly presented in intertriginous area e.g. axilla, neck, eye lid. STs are very common in middle-aged and elderly individuals. STs usually vary in diameter from 2 to 5 mm, although larger skin tags up to 5 cm in diameter are occasionally evident.
Human papillomaviruses (HPVs) are small, non-enveloped double-stranded DNA viruses. The HPV has a diameter of 55 nanometers and a genome consisting of a double-stranded circular DNA of approximately 8000 nucleotide base pairs associated with histones. Currently over 200 different types of HPV have been defined, HPVs are classified into low risk HPV subtypes e.g. 6 & 11 that are never found in invasive squamous carcinoma and high risk HPV subtypes such as 16 & 18 that induce malignant transformation.
The present study aimed to shed light on the possible role of human papillomaviruses in etiopathogenesis of skin tags, through evaluation of HPV types 6, 11, 16 and 18 in skin tags by using polymerase chain reaction (PCR).
This case-control study was conducted on 40 patients having variable numbers of skin tags lesions. They were compared with 20 age and sex-matched healthy volunteers as a control group. Patients were recruited from the Outpatient Clinic of Dermatology, Andrology and STDs Department, Menoufia University Hospital during the period from September 2017 to February 2018.
A written informed consent form was signed by each participant included in this study after informing them about the study. The study included STs patients from both sex above the age of fifteen years. Any subject having verrucae anywhere in the body was excluded from the study.
All enrolled participants were subjected to medical history and thorough clinical examination: include evaluation of body weight and height to asses BMI. Full Dermatological examination was done including determination of site, number and distribution of skin tags. Severity of skin tags was assessed according to its number into mild (1-10), moderate (10-30) and severe (≥30). Laboratory investigations including: lipid profile and serum blood glucose level were performed.
A total of 100 biopsies were collected. from each patient, excisional biopsy of one skin tag (40 lesional biopsies) and 4ml punsh biopsy of non lesional skin, 5cm away from the excised skin tag (40 perilesional biopsies) were done. from the control group, site matched 20 punsh biopsies were obtained. Multiplex Polymerase Chain Reaction (PCR) was performed to detect presence of human papilloma virus (HPV) and its low (6&11) and high (16 & 18) risk subtypes.
The result of the current study showed that: HPV positivity demonstrated a statistically significant difference between the studied groups. Our result showed stepwise up regulation from normal skin control (2, 10%) specimens passing by perilesional (5, 12.5%) and ended by lesional (19, 47.5%) specimens (P <0.001). There were non-significant associations between HPV expression and any of studied demographic or clinical data of STs patients (P > 0.05 for all).
As regard HPV genotypes, HPV genotype 6 was the most observed type that showed a significant stepwise up regulation from controls (2, 10%) passing by perilesional (3, 7.5%) and ended by lesional (11, 27.5%) skin biopsies (P=0.036). HPV genotype 11 was found in lesional (5, 12.5%) and perilesional (2, 5%). While, HPV genotype 6, 11 was found only in lesional (3, 7.5%) skin biopsies. HPV genotype 16, 18 did not observed in any studied sample.
Studying the relation between HPV genotypes in skin tags with demographic, clinical criteria and associated diseases of skin tags patients revealed non-significant associations (P > 0.05 for all).