seen in people treated heavily with methoxsalen (psoralen) and ultraviolet A (PUVA) for psoriasis (3 of 1,380 patients, 0.2%). This has also been seen in individuals with chronic immune suppression, especially from chronic lymphocytic leukemia, HIV, and previous solid organ transplant.[16,24]In 2008, a novel polyomavirus (Merkel cell polyoma virus [MCPyV]) was first reported in MCC tumor specimens with methoxsalen and ultraviolet A radiation. N Engl J Med 339 (17): 1247-8, 1998. [PUBMED Abstract]Feng H, Shuda M, Chang Y, et al.: Clonal integration of a polyomavirus in human Merkel cell carcinoma. Science 319 (5866): 1096-100, 2008. [PUBMED Abstract]Garneski KM, Warcola AH, Feng Q, et al.: Merkel cell polyomavirus is more frequently present in North American than Australian Merkel cell carcinoma tumors. J