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Epidermodysplasia verruciformis- Samia Nugali- King Saud Medical City

Abstract

 EV or Epidermodysplasia verruciformis is a genodermatosis marked by vulnerability to epidermoysplasia verruciformishuman papillomavirus infections leading to initial development of disseminated flat wart-like and pityriasis versicior-like lesions. Nearly half of all patients having EV would develop cutaneous malignancies, leading to Bowen’s type carcinoma(invasive) and squamous cell carcinomas insitu which happen mostly on sunexposed areas in the forties of fifties. A Saudi male of 55 years came to the clinic with a chief complaint of growth extending from his toe nail. He had this growth since one year and it was growing in size. The growth was painless and it extended from the hard long toe nail . Required investigations were carried out including complete blood count, LFT, ESR and skin biopsy. And a final diagnosis of Epidermo dysplasia verruciformis was confirmed. Surgical treatment is substantially quite effective. The preferred approaches include defect reconstruction with full-thickness or split-thickness grafts, complete excision or local flaps. The chemotherapy without or with radiotherapy, as in our case can be beneficial in achieving tumor’s regression/ lymph nodes before surgery. Mohs micrographic surgery can preserve the healthy tissues, which are important for these patients afflicted by multiple skin cancers and having risk of their recurrence. Another alternative option is the non-surgical treatment. Different types of non-surgical treatment methods are tried for treatment of EV, such as oral as well as topical retinoids, immunotherapy, interferon, cryotherapy and electrodesiccation. EV is essentially a genetic cancer and is of viral origin, and might also be considered as a model of cutaneous HPV oncognesis.

 Samia Nugali

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