Polyomaviruses of the Skin: Integrating Molecular and Clinical Advances in an Emerging Class of Viruses

Summary

Human polyomaviruses (HPyV) are small, non‐enveloped, double‐stranded DNA viruses that express tumor antigen proteins. 14 species of polyomaviruses have been discovered in humans, and since the 2008 discovery of the first cutaneous polyomavirus, Merkel cell polyomavirus (MCPyV), six more species have been detected in the skin: Trichodysplasia spinulosa polyomavirus (TSPyV), HPyV6, HPyV7, HPyV9, HPyV10, and HPyV13. Of these cutaneous species, only MCPyV, TSPyV, HPyV6, and HPyV7 have been definitively associated with diseases of the skin, most commonly in immunocompromised individuals. MCPyV is a predominant etiology in Merkel cell carcinomas. TSPyV is one of the etiological factors of trichodysplasia spinulosa. HPyV6 and HPyV7 have been recently linked to pruritic skin eruptions. The roles of HPyV9, HPyV10, and HPyV13 in pathogenesis, if any, are still unknown, but their molecular features have provided some insight into their functional biology. In this review, we summarize the known molecular mechanisms, clinical presentation, and targeted therapies of each of the eight cutaneous human polyomaviruses. We hope that heightened awareness and clinical recognition of human polyomaviruses will lead to increased reports of human polyomavirus‐associated diseases and consequently, a more robust understanding of how to diagnose and treat these conditions.

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