For some decades, many countries have launched campaigns to vaccinate girls and adolescents against human papilloma virus (HPV) that, in recent times, have begun in many cases to be extended to men.
There are good reasons for this. Although human papillomaviruses are practically ubiquitous in the human species, and in most cases either do not cause significant disease some or cause minor symptoms, some variants may be related to the development of very serious conditions, such as different cancers.
HPV and skin cancer
The most widespread conception of this phenomenon is that in which HPV is a sexually transmitted infection (STI) that in most people disappears on its own without causing relevant symptoms after a while, but that in a percentage of infected (mainly women) degenerates into tumors (mostly cervix, but also others such as throat, anus, vulva or penis). If we are talking about cancers caused by HPV, of course this characterization would include the majority of the instances documented in the medical literature.
However, this profile is not the only one that has been registered. Recently, the case of a woman in the United States who developed skin cancer after suffering an infection has been in the news. in a wound sustained while getting a manicure.
“Skin cancer” explains Dr. Pilar López Criado, head of the Lung, Head and Neck Tumors and Melanoma Section at the MD Anderson Madrid center, “until now it is not still related to the human papillomavirus despite the fact that this last is one of oncogenic virus best known worldwide.
“It just usually causes warts or other lesions”
“Just as the relationship between papillomavirus and gynecological and urological issues is known and handled by professionals, there is not enough knowledge of HPV-associated skin cancers for dermatologists to notice or review, although there is there is data for 10 or 15 years,” he explains.
“You have to take into account,” explains Eduardo Martínez-Arrarás, a dermatologist at the San Juan de la Cruz Health Center in Pozuelo (Madrid), “that HPV has hundreds of serotypesand those that have been linked to cancer are just a few of them.”
“Some types normally affect the skin (in the form of warts, condylomas…) and others the genitals. Those that have been most associated with cancers are from this last group. The cutaneous case is clearly rarer; it usually manifest alone such as warts or other skin lesions,” Add.
“It is a virus that lives with us”
In fact, López points out, “It is a virus that lives with us. It is known that it has a reservoir in the nails and cuticles of our hands. News like the one in the United States alerts us because taking this into account, almost in no case does it produce skin cancers or at least not cancers that can compromise life.”
Beyond the difference between the different serotypes, this has to do with the way in which infections occur: “In sexual contagion, there is closer contact, in which there may be small irritations or small bleeding which are known to be the gateways for viruses.
“Sexually, it usually happens that a person contracts it, lives with it for a while and can transmit it to others,” adds Martínez-Arrarás. “What happens is that especially in women it can produce warts and condylomas on the cervix, and then cancers at worst. In men, there are usually no symptoms and he is the transmitter, although cases of penile cancer have even been described,” he details.
“Normally” López adds, “you see the hand. Another thing is a woman’s cervix, which is not so accessible to the eye. Or even the penis and the anus are more difficult to monitor. In the hand it should not reach happen that we end up having a tumor, because the lesion must be properly monitored, treated and cleaned. That is why the case of the United States is anecdotal.”
“It is likely,” argues Martínez-Arrarás, “that this person’s case was due to a wound with material that was not properly sterilized and an infection occurred. And from there he developed cancer, very unlucky.”
“We advise vaccinating males and adults”
On the other hand, it should be noted that we have a vaccine that protects against certain serotypes, mainly those most related to cancer (which, as we already pointed out, tend to be sexually transmitted).
“There are two types of vaccine, a preventive (which in Spain is given to all girls, although oncologists advise vaccinating boys and adults) and a therapeutic one. And they are important because the exposure is very high (it is estimated that up to 80% of the world population has been in contact with the virus) and the risk of vaccination is very low,” says López.
“Right now, it is understood that the preventive vaccination it makes sense when the cancer could not develop (that is, before having been exposed to the virus; therefore, in girls who have not had sexual contact) since once the oncogenic damage has occurred, even in a cell, the vaccine does not prevent cancer,” he adds.
For this reason, he defends, “all types of sexual relations need methods of barrier protection. Including hands, sexual relations, oral… fellatio should not be performed without a barrier method, because the virus may be transmitted” (on the sidelines, he emphasizes, “of the type of relationship, heterosexual or homosexual”).
“You have to watch the manicure wounds”
And he continues: “We have seen with the pandemic how important it is to wash your hands. It is not easy to keep them clean and can transmit viruses. You have to be careful with both extremes: people who don’t wash their hands well and those who wash them excessively and end up injuring themselves.”
“Precisely, one must have Be very careful with hand injuries. Wounds that occur in beauty salons must be watched, treated and not overlooked; you have to keep an eye on them as well as possible”, he concludes.
“A wound on the hand, cleaning it, heals very quickly. If it doesn’t heal, you have to go to the doctor and if it doesn’t work insist or change the professional; it can’t be that we get to have a carcinoma” concludes.