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p16 Expression in Conventional and Desmoplastic Trichilemmomas

Hilliard, Nicholaus J MD*; Wakefield, Dara N MD*; Krahl, Dieter MD; Sellheyer, Klaus MD*‡

The American Journal of Dermatopathology: June 2009 - Volume 31 - Issue 4 - p 342-349
doi: 10.1097/DAD.0b013e3181889439
Original Study

The expression of p16 in cutaneous neoplasms is upregulated in melanocytic neoplasms, ultraviolet radiation-induced neoplasms, such as actinic keratoses and squamous cell carcinomas, and in lesions related to human papillomavirus, such as Bowen's disease and bowenoid papulosis. In cervical dysplasia and tonsillar carcinoma, there is such a close relationship between p16 and human papillomavirus (HPV) to the extent that p16 immunostaining is used as a surrogate marker for the presence of HPV proteins. In this study we were interested in the expression pattern of p16 in trichilemmomas. Twenty-six conventional and 19 desmoplastic trichilemmomas were immunohistochemically stained for p16. p16 immunostaining was noted in the majority of conventional (80.8%) and desmoplastic trichilemmomas (73.7%). The staining pattern was both nuclear and cytoplasmic. The staining intensity was more pronounced in the desmoplastic variant. We describe for the first time p16 expression in trichilemmomas and discuss our findings in conjunction with p16 expression found in other cutaneous neoplasms. Additionally, the relationship of p16 to HPV infection is critically evaluated.

From the *Department of Pathology, University of Alabama at Birmingham, Birmingham, AL; †Institut für Dermatohistologie, Heidelberg, Germany; and ‡Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL.

Supported by the Department of Pathology Adams Resident Research Grant and by the Department of Dermatology at the University of Alabama at Birmingham, Birmingham, AL.

Reprints: Klaus Sellheyer, MD, Department of Dermatology, University of Alabama at Birmingham, 1530 3rd Avenue South, EFH 414, Birmingham, AL 35294-0009 (e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.