Digital papillary adenocarcinoma (DPA) is a rare malignant tumor originating from the sweat glands, predominantly affecting the digits. DPA typically presents as a slow-growing, painless nodule on a finger or toe. It most often affects White men between the ages of 50 and 70 years with a reported male-to-female ratio of 4:1, but cases in adolescents aged 14 years up to individuals aged 80 years have also been reported. DPA has a high potential for local recurrence (reported in 30%-50% of cases) and may metastasize to lymph nodes and lungs.

In 2023, human papilloma virus 42 (HPV42) was detected on genetic sequencing studies in DPA and shown to have a pathogenetic role in its development. HPV42 has subsequently been linked to DPA tumors with aggressive clinical features, including high-grade microscopic findings and extensive squamoid differentiation. Additionally, some tumors have been shown to have BRAF mutations. These are HPV42 negative and present with less aggressive clinical features, low-grade morphology, and minimal to no squamoid differentiation.