Tesis

Hubungan antara Subtipe HPV pada Keratosis Seboroik dengan Gambaran Klinis, Dermoskopis, dan Histopatologis = The Relationship Between HPV Subtypes in Seborrheic Keratosis and Clinical, Dermoscopic, and Histopathological Features.

Pendahuluan: Keratosis seboroik (KS) merupakan tumor epitel jinak tersering terutama pada populasi usia lanjut. Beberapa penelitian melaporkan adanya HPV DNA pada sebagian kasus KS, namun peran HPV dalam patogenesis lesi ini masih menjadi perdebatan. Belum diketahui hubungan antara subtipe HPV pada KS dengan gambaran klinis, dermoskopis, dan histopatologis. Tujuan: Menilai keberadaan HPV pada lesi KS serta menganalisis hubungan antara subtipe HPV pada KS dengan gambaran klinis, dermoskopis, dan histopatologis. Metode: Penelitian retrospektif dengan desain potong lintang terhadap 32 sampel KS yang dievaluasi secara klinis, dermoskopis, dan histopatologis. Dilakukan pemeriksaan HPV genotyping terhadap 33 subtipe HPV. Analisis statistik menggunakan uji Chi-square atau Fisher’s exact. Hasil: Sebanyak 21 dari 32 sampel (65,6%) menunjukkan hasil HPV positif. Subtipe yang paling sering ditemukan adalah HPV 84/26 dan HPV 11 (lrHPV), serta HPV 16 dan HPV 18 (hrHPV). Gambaran klinis tersering pada KS HPV-positif ialah papul/nodus dengan permukaan kasar dan warna kekuningan-coklat. Gambaran dermoskopis tersering adalah fissure and ridge pattern dan comedo-like opening, sedangkan gambaran histopatologis terbanyak adalah KS akantotik yang didominasi oleh proliferasi sel basaloid. Terdapat hubungan bermakna antara lrHPVdan karakteristik permukaan lesi (p = 0,013) yaitu permukaan licin lebih jarang ditemukan pada KS dengan lrHPV positif. Tidak ditemukan hubungan bermakna antara subtipe HPV dengan gambaran dermoskopis maupun histopatologis. Kesimpulan: HPV terdeteksi pada sebagian besar sampel KS, terutama subtipe lrHPV. Meskipun terdapat hubungan antara lrHPV dan karakteristik permukaan lesi, tidak ada hubungan yang jelas antara HPV dengan pola dermoskopis atau histopatologis. Diperlukan penelitian lebih lanjut untuk mengetahui peran HPV dalam patogenesis KS.
Kata kunci: gambaran dermoskopis, gambaran histopatologi, gambaran klinis, keratosis seboroik, subtipe HPV


Background: Seborrheic keratosis (SK) is the most common benign epithelial tumor, particularly in the elderly population. Several studies have reported the presence of HPV DNA in a subset of SK cases; however, the role of HPV in the pathogenesis of this lesion remains controversial. The relationship between HPV subtypes in SK and their clinical, dermoscopic, and histopathological features has not been clearly established. Objective: To evaluate the presence of HPV in SK lesions and to analyze the association between HPV subtypes and the clinical, dermoscopic, and histopathological features of SK. Methods: A retrospective cross-sectional study was conducted on 32 SK samples evaluated clinically, dermoscopically, and histopathologically. HPV genotyping was performed for 33 HPV subtypes. Statistical analysis was conducted using the Chi-square or Fisher’s exact test. Results: HPV was detected in 21 of 32 samples (65.6%). The most frequently identified subtypes were HPV 84/26 and HPV 11 among lrHPV, as well as HPV 16 and HPV 18 among hrHPV. The most common clinical presentation of HPV-positive SK was papules/nodules with rough surface and yellowish-brown coloration. The most frequent dermoscopic features were the fissure and ridge pattern and comedo-like openings; while the most common histopathological subtype was acanthotic SK, characterised by predominant basaloid cell proliferation. A statistically significant association was observed between lrHPV and lesion surface characteristics (p = 0.013), with smooth surfaces being less frequently observed in lrHPV-positive SK. No significant associations were identified between HPV subtypes and dermoscopic or histopathological patterns. Conclusion: HPV was detected in the majority of SK samples, predominantly lrHPV. Although lrHPV was associated with specific surface characteristics, no clear associations were observed between HPV subtypes and dermoscopic or histopathological features. Further studies are needed to clarify the role of HPV in the pathogenesis of SK.
Keywords: clinical features, dermoscopic features, histopathological features, HPV subtypes, seborrheic keratosis