Missionary encounters extremely bizarre skin condition in Eastern Europe

A friend of mine has a relative who is a missionary in Eastern Europe. He recently shared photographs and the story of a man he is caring for, who has an extremely bizarre skin condition. The man has keratin-like matter growing out of the skin on hands and feet, which started when he was young, and very slowly continues to spread and grow. The areas begin as skin lesions, and the matter sprouts from those spots. The growths are very difficult to remove, and the man has so far just had to learn to live with it. There are a few medical precedents to this man's case, but nothing is certain until more tests are done. In the meantime, the missionary is helping to make life easier for the man. UPDATE: Here is the latest on this situation.

The missionary writes...

"I found this man, and other than his hands and feet, he looked and seemed in good health. As best as I could gather these growths began when he was 14 years old, and began in the area of his wrists. The skin on his wrists and the back of his hands resembles that of a hedgehog - hundreds of spike like growths. The problem is much more severe on his palms and fingers where the growths resemble very much that of nails infected with a fungus. The growths have that same texture, smell and feel. I cut a number of the largest growths off, most of witch did not bleed. Some of the smaller growths did bleed a small amount and he seemed much more sensitive to the cutting of the smaller growths. I soaked his hands first in 3 WEA (phenyl mercuric nitrate) and then began. The 3 WEA did help to soften the growths but they still took time to cut through, or sand down, but it worked just as it does with these types of nails on normal hands or feet. I was able to pull many of the smaller growths off applying steady pressure and slowly pulling. But after 1.5 hrs there was not a noticeable change as there are hundreds and hundreds of growths. There was also quite a bit of dissolved material in the bucket of 3 WEA after we finished.

On his feet I did not cut anything, but tried two different solutions of salicylic acid, one a bit weaker than the other, and also a freeze spray wart remover.

I met his mother and brother (they all live together) and their skin looked very normal. They all eat the same foods and he and his brother sleep in the same bed.

It has grown slowly but steadily but has not spread to other parts of his body, just a bit below his knees on his legs. He has other skin growth (many would be skin tags) on his face, and some moles on his chest. The growths are not as bad on his feet but I was told that more than 10 years ago many we cauterized off his feet, and they did not return. I think with repeated soaking and cutting most could be removed but other parts will I think need to be burned away in some form."

I emailed the missionary a few more questions:

Is there a medical term for this man's condition?
Doctors here have called it Lewandowsky-Lutz, though I have not been able to find any pictures of this condition to compare.

Has any analysis of the matter growing off of his skin been done?
There was 18 years ago, when they came up with the name of what they thought it was. He has not been treated since then.

When do you understand that this started with him?
He is now 38 and it started when he was 14, on one wrist. He never returned for treatments as he felt the first cauterizing was effective in that the growths did not return to that area, but felt they grew more quickly in other areas.

Does the man have any other unusual symptoms?
He appears healthy other than the growths. He has 15 skin tags on his face, and a wart in one ear.

Have there been any theories about this man's past, something he might have done, ingested, or places he's been to... that may have caused it?
As he says he did not do or eat anything his brother did not do or eat, and his brother appears to be perfectly normal, not yet. I am currently showing the pictures to veterinarians, as I am also considering that maybe this is something he got from an animal (pig, sheep, cow).

Does it look like the man's condition is treatable or curable?
Curable, I don't know. But with ongoing thorough cleaning, creams, soaking and cutting - it will be much better for him.

More photos (click for larger view):

 

Comments

[Salad Days]

I was under the impression that HPV has no cure in humans. If this gentleman does in fact have Lutz-Lewandowsky epidermodysplasia verruciformis, I think he is up shit creek.

I worked on the Wikipedia article a bit, and while adding sources came across this:

http://www.emedicine.com/derm/topic123.htm#section~treatment

which sounds pretty grim.

[Anon]

I say screw it. He's just growing his own plate armor.

[rev aaron]

I was just listening to WFMU today and didn't hear anything about this.
they were just doing the pledge thing

[ian]

If the condition is papillomavirus related, Zinc supplements my be beneficial.

http://www.findarticles.com/p/articles/mi_m0ISW/is_241-242/ai_107201186

10mg per kg per day. Zinc is a very common,cheap supplement with low toxicity. I used 50mg tablets of Zinc Gluconate to get rid of a stubborn case of foot warts. Take at night as high doses can make you queasy.

Wrapping the affected areas with duct tape over night may help to soften it for removal

[MiRRoRMaN]

I want to eat some of it. Hmmmmmm.... :)

[i got yr lewandowsky und lutz right here]

HEY! THANKS FOR POSTING THESE PICTURES, THEY'RE EXACTLY THE KIND OF THING I WANT TO SEE RIGHT BEFORE I GOUGE MY EYES OUT WITH A FORK! I TOTALLY READ THE WFMU BLOG TO SEE PICTURES OF WEIRD SKIN DISEASES!!

[BlueBerry Pick'n]

I can't stop scratching.

===

wasn't it mentioned that 'matter' dissolved in the 3 WEA solution... I wonder if it was matter trapped in, or actually the nail-like growths?

it seems as if the keratin or collagen is growing more on the glaborus tissues/areas with more contact abrasion.

What confuses me is why family or friends haven't filed down the brittle protrusions for him before he was incapacitated.

With friends like that, who needs enemies?

He really should be referred to a "wow, this is gonna get me published" (or dare we hope to find?) charitable dermatologist.

Have you thought of contacting a Canadian medical university?

[wiktor]

That's why I never wanted to be a dermatologist ;)

[curt edwards]

How did he get that sweater on?

[Matt deCamp]

I think a possible solution: it's called Squamous Cell Carcinoma presenting as cutaneous horn.

Here's more info: http://dermatology.cdlib.org/DOJvol6num1/unknowns/horn/horn2.html

[Richard]

Diagnosing a condition via a picture on the Internet? Where's Bill Frist when you need him?

But seriously, if some pre-med spots this and passes it on to the dermatology department at school, the guy just might get the real, professional help he needs.

If he does, I hope that somebody thanks WFMU.

[marthirial]

Nothing than a good korean manicure can't take care of.

[mikl paul]

that is not Gods will.

[Tia Marie]

I'm an assistant to a Dermatopathologist I'm going to ask her what she thinks ^^

[God]

I'm God.
I didn't do that! I SWEAR!
For God's sake, when will you human beings stop nagging me for everything that happens in the world?
God.

Have a nice day... or not. Only I know.

[Hy Luu]

That is awesome!

[bryce]

I am going to have nightmares from seeing that.

[HeathA]

Honestly, I'm pretty dissapointed with some of the comments made by people here. It saddened my heart to look at this; this poor guy probably lives quietly in solitude, and feels isolated from the world. He may not ever know what it's like to have a partner. His only comforts probably come from that of his family and the people who help him. I just hope he continues to stay grounded and hopeful and doesn't lose his way.

[Mark]

I suffer from psoriasis and people are very judgemental about it. I really feel for this guy and hope that a treatment is found.

[Steve_C]

I wonder if it's anything like Psoriasis which is an auto immune disease.

Would too much TNF cause this kind of problem?

[flick]

I am not a doctor, but this kinda looks like it's from arsenic poisoning, which can cause overgrowth of keratin on palms and soles of feet.

See picture on this page.

Maybe he, unlike the rest of his family, has some work exposure to arsenic, or uses an over-the-counter med or cosmetic containing arsenic?

[Kristen R.]

Intriguing and disgusting all at the same time. For this poor guy's sake, someone get to the bottom of this!

[JOJO]

NASTY...

[the invisible man]

The disease description says that lesions appear on the skin, and manifest the growths over a long period of time (inferred) when exposed to the sun.

[romanov]

I'm a phd student in virology, my subject is cutane HPVs and this disease surely looks like Epidermodysplasia veruciformis (EV, a rare genetic disease. Probably this person has some mutations in one of the two EVER genes (coding for the TMC-6 and TMC-8 proteins). This makes him more suspectible to infection with certain types of HPVs. The HPVs then cause two sorts of lesions: a wart like type and a psoriasis like type. The wart like types can develop in skincarcinomas which is probably the case for this person. A biopt of his lesion would be a bless for my research but that is probably hard to get...