Lifelong widespread warts associated with human papillomavirus type 70/85: a new diagnostic entity?

We present a patient with HPV 70/85-positive widespread cutaneous warts characterized by clinical and histological features atypical for classic generalized verrucosis or epidermodysplasia verruciformis. The cutaneous HPV infection is characterized by verrucous papules or plaques variable in size, number, and distribution depending on the genotype of HPV involved and the immune status of the patient. Human papillomaviruses comprise five genera (alpha, beta, gamma, mu, and nu papillomavirus) with different life-cycle characteristics, epithelial tropisms, and disease associations. Epidermodysplasia verruciformis (EV) is a rare, lifelong, autosomal recessive skin disease characterized by persistent cutaneous human papillomavirus infection not necessarily associated with immune system defects. The disease results from an unusual genetic susceptibility to infections with various types of HPVs (especially ß-HPV), some of which cause malignant transformation. Conversely, generalized verrucosis has been more typically associated with generalized warts, which are associated with immunocompromised conditions.

Epidermodisplasia verruciforme: reporte de una serie de casos / Epidermodysplasia verruciformis: report of a case series

La epidermodisplasia verruciforme es una genodermatosis rara que condiciona una susceptibilidad anormal a infecciones por el virus del papiloma humano, presentando lesiones cutáneas con potencial oncogénico. Objetivo: determinar la frecuencia de epidermodisplasia verruciforme y caracterizas los hallazgos demográficos, clínicos y terapéuticos de los pacientes que acudieron a la Cátedra de Dermatología del Hospital de Clínicas, entre los años 2003, 2012. Material y métodos: se realizó un estudio descriptico de pacientes con diagnóstico clínico e histopatológico de epidermodisplasia verruciforme. Resultados: se encontraron cinco casos. Todos los pacientes iniciaron el cuadro en la infancia y presentaron lesiones tipo pitiriasis versicolor y verrugas planas. Todos refirieron exposición solar crónica y familiares de primer grado con la misma enfermedad. La neoplasia más frecuente fue al enfermedad de Bowen, seguida del carcinoma epidermoide infiltrante. Los tratamientos incluyeron cirugía, crioterapia y 5-fluorouracilo tópico...

Epidermodysplasia verruciformis is a rare genodermatosis characterized by an abnormal susceptibility to human papiloma virus infection, developing cutaneous lesions with oncogenic potential. Objective: To determine the frequency, clinical demographic and therapeutic characteristics of patients who attend to the Dermatology Department of the Hospital de Clinicas between 2003 and 2012. Methods: A descriptive study of patients with clinical and histopathological diagnosis of epidermodysplasia verruciformis was carried out. Results: Five cases were found. Childhood-onset of disease, pityriasis versicolor-like lesions and flat warts were seen in all cases. All patients reported chronic sun exposure and first-degree relatives with the same disease. BowenÆs disease was the most frequent neoplasm, followed by invasive squamous cell carcinoma. Treatment modalities included surgery, cryotherapy and topical 5 fluorouracil. Discussion: Consistently to the infrequent nature of the disease, only five cases were diagnosed in the years. Unlike other studies, BowenÆs disease was the predominant neoplasm...

Epidermodysplasia verruciformis after cutaneous T-cell lymphoma: Periungual presentation.

Epidermodysplasia verruciformis (EV) has several clinical presentations and has been reported in various states of immune deregulation. We report the unique presentation of this disease as a pigmented periungual macule in a patient with a previous history of immune deregulation related to cutaneous lymphoma. A literature review did not reveal any previous reports of EV in patients with cutaneous T-cell lymphoma.

Surgical treatment of epidermodysplasia verruciformis.

BACKGROUND: Epidermodysplasia verruciformis (EV) is a genodermatosis, characterized by human papilloma virus infection, with polymorphic and disseminated lesions that develop malignant transformation in approximately half of patients. MATERIALS AND METHODS: We describe clinical and epidemiological features of 10 cases of EV during a 5-year period. All were treated using curettage of the nonmalignant wart-like lesions with a curette and application of 35% trichloroacetic acid (TCA) with a cotton bud for a few seconds. RESULTS: Ten patients aged 33 to 67, nine women and one man, were treated, mainly presenting flat, brownish, wart-like lesions distributed on the anterior and posterior trunk. Two patients developed squamous cell carcinoma, histologically confirmed, that was surgically removed using fusiform excision. Good cosmetic results were obtained, and there was no reappearance of lesions during a mean follow-up of 3.5 years. CONCLUSION: Curettage and application of 35% TCA that we have used in these patients has been shown to be an effective and low-cost alternative, compared to oral, topical, or other physical ablative therapies, with satisfactory cosmetic results and no recurrence during follow-up.

Epidermodysplasia Verruciformis with severe hand and foot deformity successfully treated with surgical excision.

Epidermodysplasia Verruciformis is a rare skin disease due to human papillomavirus (HPV) infection. We report here a male patient of 39 years with severe giant lesion of hands and feet leading to disability for 20 years. The function of the hands was almost lost. We treated the case with the shaving technique and a satisfactory result without recrudescence in the following two years. No apparent scarring resulted.

Candidiasis hiperplásica crónica de la mucosa oral / Chronic hyperplastic candidosis of the oral mucosa

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Epidermodysplasia verruciformis: an unusual presentation.

BACKGROUND Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genetic disorder of the immune system manifested by increased susceptibility to cutaneous human papillomavirus (HPV) infection beginning from the early years of life, and compromising lesions resembling flat warts, especially on the distal extremities and the face; but malignant transformation occurs in sun-exposed areas within the third or fourth decade of life. OBJECTIVE We describe two case reports of epidermodysplasia verruciformis, one of which was onset and had more aggressive features than the usual presentation. METHODS Intermittent surgical excision of the tumoral lesions were performed in the first case, whereas only one surgical intervestion was sufficient in the second case. RESULTS The early onset case was more aggressive, and new tumoral lesions were seen, whereas the other patients was free of the disease for 2 years.CONCLUSION Epidermodysplasia verruciformis possess multi factorial etiologies, and the main prognostic factor of the behavior of the disease may be the family history and genetic susceptibility.

[Surgical treatment of excessive hyperplasia symptom of skin keratosis at the limb ends].

OBJECTIVE: We introduce the experience of treating 10 cases with excessive hyperplasia of skin keratosis at the limb end. There were 9 cases of palmar and plantar keratosis and 1 case of epidermodysplasia verruciformis. METHOD: All cases received the operation of lesion excision and skin grafting except 2 cases who received skin flap for defect covering after lesion excision because of deep tissue exposure and postradiation ulcer. RESULT: The operative effects were satisfactory after 8 years of follow-up. No recurrence was found in all cases and all patients resumed normal activity. CONCLUSION: The effect of the skin flap is better than skin graft at the plantar area. Because of lack of fibrous septum in the subcutaneous tissue, the flap, often moving during walking, is liable to trauma and ulceration. The operation area must be well protected.

Skin autografts in epidermodysplasia verruciformis: human papillomavirus-associated cutaneous changes need over 20 years for malignant conversion.

Epidermodysplasia verruciformis (EV) is regarded as a model for cutaneous oncogenesis associated with specific human papillomaviruses (HPVs). Because genital HPV-associated carcinogenesis is a very long-lasting process requiring 20-30 years and epidemiological studies of this type for HPV-associated skin cancers are impossible in such a rare disease as EV, we observed for up to 20 years EV patients having surgery for carcinomas with consecutive autografts from uninvolved and non-sun-exposed skin. We noticed the appearance of premalignant and malignant changes around the grafts, whereas within the grafted skin, only benign macular lesions started to develop several years after transplantation. Thus, skin HPV-associated carcinogenesis appears to be a very slow process comparable to the genital carcinogenesis associated with high risk HPVs.

Serial transplantation in SCID mice of an epidermodysplasia verruciformis-associated squamous cell carcinoma without alteration of its histological and virological features.

An epidermodysplasia verruciformis-associated squamous cell carcinoma was xenografted to a SCID mouse, and the resultant tumor was transplanted through mice for 10 generations. Histological and virological features, with replication of about a thousand copies of the papillomavirus DNA, were the same in both the original carcinoma and the transplanted tumors.