A groundbreaking study from the National Institutes of Health in the United States has confirmed for the first time that a form of human papillomavirus (HPV) commonly found on the skin—beta HPV—can directly cause skin cancer in individuals with severely weakened immune systems. The findings, published recently in the New England Journal of Medicine, have significant implications for how some skin cancers may develop and reinforce the importance of vigilant health monitoring in immunocompromised populations. For Thai readers, this development is particularly relevant given the rising rates of both non-melanoma skin cancer and immunosuppressive conditions in the region.
Skin cancers—particularly cutaneous squamous cell carcinoma—are most often caused by DNA damage from ultraviolet (UV) radiation from the sun. For decades, HPV has been known as a causative agent in cervical and other anogenital as well as oropharyngeal cancers, with “alpha” HPV strains being the primary culprits. Beta HPVs, in contrast, are ubiquitous on healthy skin and long believed to play only a supporting role in promoting cancer. The new report overturns this assumption, showing that in rare cases where the immune system is severely compromised, beta HPV can act alone as a direct driver of skin carcinogenesis.
The discovery emerged from the case of a 34-year-old woman with a rare genetic disorder that led to T-cell immunodeficiency. Over several years, she developed 43 cutaneous squamous cell carcinomas on her face, hands, and legs, requiring repeated surgeries and immunotherapy. Despite these interventions, her cancers kept returning. After detailed analysis, her medical team found that beta HPV had integrated its DNA directly into the skin cells—triggering oncogenic transformation. According to the senior author, section chief at the National Institute of Allergy and Infectious Diseases, “the virus replicated in a somewhat uncontrolled manner and ended up integrating into the skin cells and once they did that, they became cancerous” (NBC News).
Beta HPVs are present on the skin of approximately 90% of the population and are typically harmless due to an intact immune system that keeps the virus under control. “We shake hands and we pick up those viruses, but if our immune systems are under control, we are fine,” explained the NIH expert. In this patient, a stem cell transplant to restore T-cell function led to complete remission of her skin cancers, which have not returned in three years of follow-up.
Dr. Anthony Oro, a dermatology professor at a leading US university not involved in the research, noted, “It suggests that, in the event that the T-cell arm of the immune system is not doing its job, beta-type HPV viruses could contribute to skin cancer, and maybe other kinds of cancers as well.” Echoing this, a dermatologist and Mohs surgeon at a major US cancer center, observed that while HPV integration into DNA is well-documented for alpha strains, this demonstrates “it was a beta HPV that integrated into the DNA” in human skin—a finding previously seen only in mice models (news-medical.net).
For Thailand, where UV exposure is high year-round and organ transplantation rates are increasing, the implications are substantial. Immunocompromised individuals—including those on long-term steroids for autoimmune diseases, cancer patients receiving chemotherapy, HIV-infected persons not on effective treatment, and post-transplant recipients—face up to 100 times higher risk of developing squamous cell carcinoma compared to the general population (NEJM). Dermatology experts interviewed for this report stress that, while the new findings are based on a rare case, they underline the need for extra vigilance and regular skin checks among at-risk groups in Thailand.
In historical context, skin cancer has been less of a concern in Thailand than in temperate, fair-skinned populations, but this is changing with longer life expectancy, greater awareness, and shifting patterns of immunosuppressive illnesses. The scientific consensus remains that UV radiation is the chief cause of most squamous cell carcinomas, with HPV-related cases being exceedingly rare among people with a healthy immune system (Wikipedia). However, as more Thais receive immunosuppressive therapies or undergo organ transplants, the direct role of viruses like beta HPV may become increasingly significant.
Currently available vaccines such as Gardasil target alpha HPV strains—responsible for cervical and other mucosal cancers—but their efficacy against beta HPV is unknown. “Even if this strain is not in the vaccine, there is some theory that there is cross-talk between HPV strains,” said the Mohs surgeon. Most Thais and indeed most people globally are infected with HPV at some point in their lives, usually with no symptoms or ill effects. About 200 HPV types have been identified, with alpha types long known to cause cancer and beta types only now emerging as independent cancer culprits in specific contexts (mdpi.com).
Looking forward, experts anticipate intensified research on the molecular mechanisms by which HPV interacts with immune surveillance in the skin, especially under immunosuppression. “This suggests that this other side of the family might also be important in situations where our immune system is not doing its job,” commented the Stanford dermatologist. The case report may prompt new strategies for monitoring, early detection, and possibly even antiviral therapies tailored for immunocompromised patients at high risk of skin cancer.
For Thai readers, the practical takeaway remains clear: diligent sun protection—through regular use of sunscreen of SPF 30 or higher, wearing protective clothing, and minimizing sun exposure during peak hours—is still the best defense against most types of skin cancer. Immunocompromised individuals, including transplant recipients and people living with HIV, should discuss regular dermatologic evaluations with their healthcare providers. While this case of beta-HPV–induced skin cancer remains extremely rare, it highlights the critical interplay between viral infections and immune health in cancer risk. Further, the findings reinforce the broader public health message about the importance of HPV vaccination in preventing the most common, vaccine-preventable HPV-related cancers.
For Thai healthcare professionals and policymakers, this new evidence underpins calls for multidisciplinary care for immunosuppressed patients, increased accessibility to dermatologic screening services, and ongoing community education about both skin cancer prevention and the evolving landscape of infectious cancer risks.
Sources:
- NBC News: A type of HPV has been found to cause skin cancer, according to a new report
- New England Journal of Medicine: Resolution of Squamous-Cell Carcinoma by Restoring T-Cell Immunity
- News Medical: Immunocompromised people susceptible to skin cancer caused directly by beta-HPV
- Wikipedia: Human papillomavirus and skin cancer
- MDPI: The Role of HPV in the Development of Cutaneous Squamous Cell Carcinoma