Epidermodysplasia Verruciformis: Who gets this disease, Diagnosis, Causes and Treatment

epidermodysplasia verruciformis article

Also known as Tree man disease, it is a congenital skin condition, caused by a disorder of the immune system.

Patients with this rare disorder do not develop antibodies to fight many of the Human Papilloma Virus (HPV acronym) diseases, and they get permanently exposed to that virus infections.

HPV infections are in the form of warts, and in these patients develop warts massively across the skin surface. Especially in the backs of the hands, legs, face, and neck. For this reason, it is that the disease is commonly known as tree disease man.

Warts appear, disappear and reappear in different parts of the body. Over the years, the disease gets worse, and moles are increasingly large and invasive.

Also, between 30 and 70% of patients with epidermodysplasia contract skin cancer. However, it remains unclear exactly how this disease becomes cancer.

Who gets this disease?

The origin of this disease is genetic and transmitted through a recessive gene. Therefore it is necessary that both parents have at least one copy, this makes it a rare disease.

Medical experts estimated that approximately 10% of patients with epidermodysplasia verruciform arise related couples familiarly.

In more than 60% of cases, the patients manifested the condition during childhood, between 5 and 11 years.

About 22% during puberty and only 7% displayed the disease before age 5. The remaining are exceptional cases of individuals who develop the disease in adulthood.

Also, a small percentage of people who get this disease without having the genetic mutation, because of suffering from other diseases such as HIV infection or lymphoma.

How is it diagnosed?

The diagnosis of epidermodysplasia verruciformis it is clinical; however, several experts recommend some preclinical studies that could be useful when there are no apparent features joint injuries, or when trying to identify the kind of virus.

Some of these resources are histopathology, electronic microscopy, viral typing by chain reaction (PCR) and ELISA.

The criteria for diagnosing epidermodysplasia verruciform are listed below:

  • Start early childhood.
  • In some cases their consanguinity and predisposition family.
  • There are features skin disorders, such as
  • Flat warts like lesions (on the back of hands) and tinea versicolor, and red plates or light brown (neck and thorax), irregular or
  • Polycyclic.
  • A persistence of skin lesions with progression slow.
  • It does not affect mucous membranes and lymph nodes.
  • Right general conditions, with no apparent damage.
  • Conversion of some malignant lesions, mainly in the fourth and fifth decades of life, in sun-exposed areas (face) and traumatized.}


The cause of this disease is mostly genetic. Therefore, there is no complete and definitive cure.

This condition is an autosomal recessive inherited disorder. Which means that for this disease to manifest in a person, the patient would have to carry two abnormal genes mutated by this genetic disorder, one gene from each parent.

But in some cases, these genes can still be passed on to future offspring.

A few studies show that about 10 percent of people with Epidermodysplasia Verruciformis shared a common ancestor who suffered from this condition.

Each case of this disease is unique. The images that we show are extreme cases serve to illustrate how severe this condition can be. Coincidentally, medical experts found the most extreme cases in parts of Asia and Oceania, but this disease not only develops in these locations.

There is no scientific evidence to support that it is a disease specific to specific regions, races or customs.

People who suffer from Epidermodysplasia Verruciformis have a weak immune response to several kinds of wart viruses.

Is there a treatment for this disease?

The treatment consists of preventive measures to reduce the risk of cancer.

Also, each wart can be treated individually with chemicals or even get removed. But warts will continue to appear, and there is no known measure to prevent it.

In the most advanced cases of cancer, medical experts can perform a graft with healthy skin not exposed to the sun.

As explained before, there is no method to eliminate this disease. But some experts suggest pretty efficient ways to deal with this condition, such as treating the patient with acitretin (Soriatane) and interferon.

During the earlier stages of the disease, it is essential to remove warts and any other potential tumor before they get worst. The best treatment is to prevent these warts from growing.