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Epidermodyplasia verruciformis (Tree Man Disease)

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Destiny Anudike-Uzomah

on 21 July 2015

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Transcript of Epidermodyplasia verruciformis (Tree Man Disease)

Epidermodyplasia verruciformis
[Tree man's disease]

Epidermodysplasia Verruciformis(EV) is an immune deficiency. It is a failed human response to the Human Papillomavirus (HPV) Type 2 and is believed to stem from a genetic defect.
There are 3 known people with the disease

Dede Kosawa,

but 195 cases have been reported throughout history.
Dede and Zainal are both from same area in Indonesia. Ivan is from the Netherlands, however, his dad
grew up in Indonesia. All three men have genetic roots in Indonesia. They originated in West Java.

Effects on the body
Flat wart-like lesions
Plaque-like lesions
The palms, soles, armpits and external genitals may also be involved.
The disease manifests as an inborn kind in infancy, during childhood, or at puberty.

The disease normally manifests as small flat warts in very young people.
Patients with EV are immunotolerant towards own EV HPVs throughout the whole life, whereas the oncogenic types of EV HPVs induce cancers.
Medical Interventions

Strict sun avoidance and protection from sun through the use of sunblock everyday. Exposure to sunlight (UVB and UVA) has been shown to increase the rate of EV lesions turning into skin cancers.

·Also avoidance of other oncogenic factors like X ray radiation.

Imiquimod (Aldara) is a prescription medication that acts as an immune response modifier.

Oral and topical treatment with retinoids and Aldara are proving to be useful agents.
Surgical Procedures
Treat and remove warts, as you would treat other viral warts. This includes chemical treatment, cryotherapy.
(Cryotherapy refers to a treatment in which surface skin lesions are frozen.) In this case with the use of liquid nitrogen.

Electrosurgery destroys abnor(In electrosurgery, high-frequency, alternating electric current at various voltages (200 to 10,000V) is passed through the skin to generate heat.) it destroys abnormal skin growths.
EV is a rare, autosomal recessive inherited skin disorder characterized by eruptions of wart-like lesions that may occur anywhere on the body.
Caused by infection of the human papillomavirus (HPV)
patients with EV have an abnormal or impaired immune response to HPV or wart viruses
autosomal recessive inherited disorder- means both parents must pass on EV genes
has been found that 10% of patients with EV come from marriages between blood relatives
patients with impaired immunity due to HIV or a lymphoma have a higher risk of contracting EV
Detail 2
Presentation by:

Destiny Anudike-Uzomah-Lee's Summit High School

Madison Bowler- Bishop Kelley High School

John Chazhoor-Rockhurst High School

In addition, a balanced healthy diet coupled with fresh fruits and vegetables should also be observed, as this may be beneficial to the patient’s skin health, as well as overall health.

Features of EV
Flat, wart-like lesions that look like warts or plaques.
Warts can be flat-topped papules ranging from light pink to violet in color.
Some areas of papules can join together to form large plaques
Wart-like lesions appear on sun-exposed areas such as hands, feet, face, and ear lobes
The warts occur in clusters and can be anything from a few warts to over a hundred warts.
A major concern of EV patients is that the lesions may transform into skin cancers
Exact reason why is unclear but exposure to sunlight or UV rays may be cause of transformation into cancer
Potential of EV to turn into cancer may depend on type of HPV present
More than 90% of EV-associated skin cancers contain HPV type 5, 8, 10, and 47.
Types 14, 20, 21, and 25 usually remain benign

Due to the extremely rare immune system deficiency, their bodies are unable to contain the warts.


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