Epidermodysplasia verruciformis also known as Lewandowsky-Lutz dysplasia is a unique genetic disorder. It is also known as the tree man illness syndrome in which the skin develops higher and abnormal vulnerability to HPVs or human papillomaviruses in the skin. This causes critical infections and results in scaly skin with papules mostly on the hands and feet. This disorder can affect people of any age group. However the ones between the ages of 1 to 20 are more susceptible. The cause of this condition is inactivation of PH mutation in the genes that are responsible for maintaining the amount of zinc in the cell nuclei. Zinc is essential for various viral proteins which get affected by the mutation.
In the year 2007 a video of an Indonesian man called Dede Koswara in his early 30s went viral. The video revealed his shocking skin condition and also telecasted on the TLC series and Discovery channel. Due to Epidermodysplasia verruciformis he has massive warts, and horns on his hands. He got almost 13 lb of the warts removed through a surgery in 2008. Almost 95% of the warts from his body’s different parts were removed. It was also documented by channels such as TLC and Discovery. But this critical surgery was not the end to Dede’s problems as his warts keep returning. According to the doctors he would need surgeries twice a year throughout his life. The discovery channel also funded a blood analysis for him where it was found that he is devoid of the antigen in immune system needed to prevent yeast infections. The permanent treatment for Dede’s problem was discussed with him and he was also offered help but he refused.
Symptoms of Epidermodysplasia verruciformis:
- Papules like warts
- Formation of Cutaneous Carcinomas.
- Eruption of macules that are flat, scaly and reddish brown in color, usually appearing on the neck and face, genital areas
- Lesions that are like warts
- Papules on hands, face that are pinkish red in color
- Formation of multiple cutaneous tumors.
Epidermodysplasia verruciformis or EV doesn’t have a serious treatment yet. Most of the patients take acitretin, interferons and retinoids. Cimetidine is also another depressant that has been widely used but recent studies indicate its ineffective nature. Applying topical calcipotriol has shown one of the best results. However the most important part is to diagnose the disorder at the earliest as well as the Excision lesions and tumors.
Dede Koswara became popular because of his rare skin condition. he became a subject of medical curiosity and came to be known as the Tree Man as he had bark like protrusions form almost every end of the body as well as face. He lost his job as well as wife because of this strange disorder after which he had no choice but to be a part of a traveling freak show after which he came to be known as the “Tree Man of Java.” His case of EV is the most extreme and complicated.
Dede Koswara – Tree Man (Pictures)