“…As an example, human papillomaviruses (HPVs), which comprise a group of 441 different types belonging to 5 distinct subfamilies, can cause a spectrum of skin disorders with a phenotypic range from self-limited cutaneous warts, some of which can become recalcitrant to genetically determined conditions, such as epidermodysplasia verruciformis and the Tree man syndrome ( McBride, 2022 ; Uitto et al, 2022 ). Many families have a well-defined immune deficiency due to compromised T-cell immunity or the keratinocyte-intrinsic immune system ( Biglari et al, 2024 ). In addition to genetically determined susceptibility to viral infections in patients with primary immune deficiency, many cases have been documented where the cutaneous lesions are associated with acquired immune deficiency, for example, secondary to acquired immune deficiency syndrome or human T-lymphotropic virus 1 (HTLV1) infections ( Akinboro et al, 2013 ; Cockerell, 1991 ; Valencia and Moreno, 2017 ).…”