Epidermodisplasia verruciforme

Abstract

We present the case of a 50-year-old Latin American woman who consulted her physician because of recent pruritic lesions on her arms and thighs. During the examination, we observed multiple flat papules on the limbs, as well as hypopigmented macules on the trunk which, according to the patient, began to appear during childhood. A histological study was performed on both types of lesions, and showed some enlarged keratinocytes with light blue cytoplasm in the upper layers of the epidermis. More than 20 types of HPV associated with EV (HPV-EV) have been described. Although it was previously thought that these were specific to EV, new molecular biology techniques have made it possible to isolate HPV-EV sequences in skin diseases, both benign and malignant, with epidermal hyperproliferation in the immunocompetent population.

Surgical Treatment of Epidermodysplasia Verruciformis

“…In most cases, an autosomic recessive inheritance determines it, although some cases of autosomic dominant and X‐linked inheritance have been described. It is believed that defects in cellular immunity that determine an inability to recognize and reject the antigen presenting keratinocytes of the EV‐HPV cause EV 1 . Up to 50% of patients develop nonmelanoma skin cancer later in life, mainly on sun‐exposed areas.…”

“…Metastases usually occur only in tumors irradiated with gamma rays. Radiotherapy previously applied against squamous cell carcinoma together with sun exposure may cause early malignant transformation of skin lesions and destructive tumors 1,2,4 . We noticed low rates of malignant transformation in our series; only two patients (20%) developed squamous cell carcinoma on the trunk, although longer periods of follow‐up are needed.…”

“…Epidermodysplasia verruciformis (EV) is a rare genodermatosis, first described by Lewandowski and Lutz in 1922 1 . It is a chronic disease characterized by a special susceptibility to human papilloma virus (HPV) infections, known as EV‐HPVs.…”