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Tree Man

A very detailed presentation about the disease Epidermodysplasia Verruciformis and about a man with the disease, Dede Koswara.
by

Jessica Livingston

on 28 November 2012

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Transcript of Tree Man

Tree Man Epidermodysplasia Verruciformis Dede Koswara Questions/Answers What System(s) of the Body does EV affect? How did Dede's Warts First begin to form? How Many Surgeries did Dede undergo? The Story of Dede Who is Dede? Breaking It Down What is EV? 'Tree Man of Java'
35 year old fisherman from Indonesia
When he was a teenager, he cut his knee and ever since then, strange growths have covered his body.
These strange growths on his hands and feet look like tree roots, and large patches of his skin resemble the bark of a tree. The story of Dede's condition begins almost 30 years ago when he was a young boy. While he was out in the forest near his home on the island of Java in Indonesia, Dede cut his knee. Shortly after wards, small warts started to sprout around the wound, which eventually spread to his feet and hands.
As he grew older, the warts continued to grow. Eventually, the vast number and size of them hurt his ability to work and earn a living. Although, he claimed that his warts didn't hurt or itch, but they gave off a sickening odor. Doctors began to use chemotherapy to bring the virus under control, but the treatment was cut short after Dede's liver began to fail. Then the warts started to return.
Unfortunately, after this point, political complications led to conflicts and disagreements between Gaspari and Indonesian officals. Although, once matters were dealted with, doctors began a second round of surgery but the warts on Dede returned just like before. Gaspari believes that a full recover can be achieved by doing a bone marrow transplant and other procedures. Sadly, procedures like those are not available in Indonesia, which is halting Dede's treatment plans. Jessica Livingston
3rd Period Anatomy
Wolfe, 2012 1.) Epi- upon 3.) Dysplasia- abnormality of development 2.) Derm- skin EV EV is an extremely rare inherited skin disorder.
Belongs to a group of autosomal recessive genetic disorders.
Carries a very significant risk of skin carcinoma.
The skin is covered with lesions, which are caused by infection with the Human Papillomavirus. A lesion is any abnormality superficial growth of the skin.
Once the person is infected with HPV the disease starts to form scaly *macules and *papules.
These skin changes mainly affect hands and feet.
Affects the Integumentary System and Immune System.
The characteristic skin changes basically develop after the exposure to HPV types 5 and 8.
Usually starts between the age of 1 and 20 and there were also cases when middle-aged people were affected. At the age of 28, his wife left him because he was unable to work and provide for her and their two children. Dede ended up traveling with the circus to earn a living. It was while he was there that a photo of him posted online attracted attention. The attention soon gave him his treatment. In 2008 he received treatment once a U.S. dermatologist determined his condition. Dede was soon visited by Gaspari who developed a treatment program and worked along side Indonesian surgeons to remove 30 pounds of warts and decaying matter by using an electric saw. It was determined that Dede had contracted the HPV, a condition that causes warts, which began to develop when he was a child. However, a rare immune deficiency allowed the warts to grow out of control, leading to root like barnacles known as cutaneous horns that eventually covered his upper and lower extremities.


"He is like a patient which HIV, but it is negative. Since his immune system is so low, it is easy for other infections to enter his body."
-Gaspari, Team Leader of his Treatment Program Dede's Diagnosis
Cutaneous- pertaining to, or affecting the skin


Upper Extremity- shoulder, arm, forearm, wrist, and hand

Lower Extremity- hip, thigh, leg, ankle, and foot EV affects the Integumentary and the Immune System They began to form when he cut his knee when he was a child in the forest. Dede went through two surgeries How many pounds of warts and decaying matter did the doctors remove from Dede's body? They removed up to 30 pounds! What does EV stand for?
What does HPV stand for? Epidermodysplasia Verruciformis Human Papillomavirus What kind of patient did Gaspari refer Dede to? "He is like an HIV patient, but negative." What is a Lesion of the skin? A lesion of the skin is an abnormality superficial growth on the skin. What does Epi stand for?
What does Derm stand for?
What does Dysplasia stand for? Upon Skin Abnormality of development Works Cited http://medical-dictionary.thefreedictionary.com/
http://atlasgeneticsoncology.org/Kprones/epiderm_ver.html
http://articles.latimes.com/2010/jul/16/world/la-fg-indonesia-treeman-20100716
http://www.telegraph.co.uk/news/worldnews/1569156/Tree-man-who-grew-roots-may-be-cured.html
http://www.telegraph.co.uk/news/worldnews/1569156/Tree-man-who-grew-roots-may-be-cured.html
http://dictionary.reference.com/
http://www.streetdirectory.com/travel_guide/113285/medical_conditions/epidermodysplasia_verruciformis__information__treatment.html HPV-5 *Cornified- Formed of a horny layer of skin or skin structures such as nails or scales.
*Epithelium- The thin tissue forming the outer layer of a body's surface. infects *cornified *epithelium
most common type found on normal skin
belongs to the types frequently associated with skin cancers of EV patients. HPV-8 poses a high risk for *malignant conversion of skin lesions in patients with EV.
causes skin cancer along with HPV-5. *Malignant- (of a tumor) Tending to invade normal tissue or to recur after removal; cancerous *Macules- a patch of skin that is discolored but not usually elevated; caused by various diseases.
*Papules- a solid raised skin lesion with a distinct borders. Papules may have different of shapes and is sometimes associated with other features such as crusts or scales. Mild Case of EV The History of EV was first described by Lewandowsky and Lutz in 1922 Treatment Options Current treatment for this disease includes the use of liquid nitrogen to freeze off the warts or by using *Retinoids. The other form of treatment is surgically removing the warts that turn into cancer. These treatments help slow down the disease but they do not prevent new warts or cancers from forming. Retinoid- a class of chemical compounds that are related chemically to vitamin A. They are used in medicine, primarily due to the way they regulate epithelial cell growth.
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