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March 12, 2007

Comments

Sean

I've been haunted by these images since I saw them yesterday. I'm really hoping for a follow up post of a much improved patient to ease my mind.

Jakob

I will never eat pop corn chicken again.........

BUBBLE

OMFFG ITS HORRID WHAT THE HELL IS WRONG WITH HIM OH DEAR GOD I AM GOING TO SPEW!!

Tyler

UGH!!! I think Im about to......PUKE!!!!!!!

chad

I just want to sit there and pick at it with a pair of small scissors.

daku

the invisible man:

You should definitely try to procure a biopt sample; I may be assuming things here, but it may not be that hard to get considering that the pictures made it onto the net in the way that they did. It might be worth your time to dig in.


Please, do let us know if you choose to pursue this particular case because I, for one, have not been able to get this out of my mind since I first saw the images. If something can be done for this person as a result of this forum's posting, it would be a good thing.

Sherri

ValJonesMD's blog posted about it (I guess it's making the rounds already). A comment from StephenStoneMD, a past President of the AAD, commented that it's "epidermodysplasia verruciformis of Lewandowsky and Lutz, the condition is now known simply as epidermodysplasia verruciformis".

I found an article, 'Epidermodysplasia Verruciformis' by Grace F Kao, MD, which states: "Background: Epidermodysplasia verruciformis (EV) is a rare, lifelong, viral-mediated, autosomal recessive (Sex-linked and autosomal dominant inheritance patterns have also been reported.) hereditary disorder affecting the skin. The disease is characterized by chronic infection with human papillomavirus (HPV). Widespread skin eruptions of flat-to-papillomatous, wartlike lesions and reddish-brown pigmented plaques on the trunk, the hands, the upper and lower extremities, and the face are characteristic."

If that's what this young man has, then hopefully the treatments listed in the above article might help.

anon

Horses sometimes get very similar growths in their ears. They are thought to be caused by a virus and aggravated by irritations caused by flies and gnats. Veterinarians remove them (after sedating the horse) by scraping, but they come back immediately. Cauterization seems to last longer but is not totally effective. I wish I could give you more information, but I've only seen the removal process and I am not a vet. Perhaps one could help you out. I wish you the best.

Mike

I've been looking at those pictures for the past hour trying to make my self immune to them. I would like to report that it still bothers me, but not as much as an hour ago.
I book marked this page, so when I have a bad day, I no my problems are nothing compared to what some people go through every day.

Do those grow on the bottom of his feet?

Felix Kasza

To the commenters who mentioned Chernobyl -- if the patient is 38 now, and was 14 when the symptoms began, the onset was actually _before_ Chernobyl.

Interesting article -- http://www.emedicine.com/derm/topic589.htm Apparently, there are ways to treat the symptoms or at least make them milder.

Tony

"Fantastic!

Is this considered doing God's work, or undoing it?

Posted by: jim | March 12, 2007 at 02:37 PM"

If this is God's work, then God's a big asshole.

Chris R.

I have to say that I'm impressed by the level of concern by most posters; this only cements in mind that WFMU people are good people!

marie

I agree that this looks like epidermodysplasia verruciformis with cutaneous horns. Horses do get similar warts in their ears (Aural plaques) but they are not really equivalent to EV, other than being caused by PV infection. I'm not sure if this has been tried in patients with EV (I am a veterinary pathologist), but the drug imiquimod (Aldara) has been used successfully to treat warts and precancerous bowenoid lesions/squamous cell carcinoma in situ, in people. Veterinarians have used this drug with good success in treating cats with PV-induced bowenoid dermatosis. I'm not sure but you may need to exfoliate the lesions and perhaps treat with retinoids as well - in order for the imiquimod to be absorbed. Interferon has also been used in conjuction with the imiquimod when treating PV-induced skin lesions. Perhaps the real danger with this disease is progression to squamous cell carcinoma in UV exposed areas of the body. Not to downplay the psychological trauma of this sort of disfigurement.

Fuzzy Dragon

Seriously, if samples can be taken and sent to some of the interested dermatologists that have posted here, there might be a treatment or something available for this guy. I know psoriasis can have a very deleterious effect on one's quality of life, something like this would destroy a life. If there's a way to return this guy's life to him, it should be pursued.

OhPiffle

I thought you might like to research this article.

http://jvi.asm.org/cgi/content/full/76/22/11209

heavenlymayday

Poor guy. I hope that they figure something out to help him. :(

Niels Olson

More I think about it, I wonder if it's such a good idea to be cutting these things down. He's probably got quite a viral load in those things, and stands a chance of of getting viral particles into his venous circulation, which would rapidly facilitate the systemic spread of the infection. It's not like you're ever going to win the battle by cutting them down. Does the debulking improve quality of life? I'm sure perfect debulking would, but functionally safe debulking? We really can't just look at this and know where it ends and his blood-bearing skin begins. Maybe a hand surgeon with a some 3D reconstructions from CT and MRI could do it, but would that improve the success of medical treatment, which this ultimately would need? Probably somewhat, but, yeah, he needs to go in. If commenters want to do something, find out where the nearest medical schools are, and get directions.

Niels Olson

Also, if he hasn't been seen for 18 years (?!), I don't know if the antivirals were around at that time. Acyclovir, gancyclovir, valcyclovir are some of them.

mason

I remember seeing a man with a similar condition in the early 1980s at the University of Pittsburgh. Ten years or so later I remember seeing him again and noticing that his hands were normal. Since I didn't know the guy I didn't ask him about it, but one of the University hospitals in that area might be a lead for you.

Talia

And I thought my skin was weird...http://taliaslife.wordpress.com/2007/03/13/my-real-life-superpower/

Cass Tolley

What would happen if these areas were sealed off in honey with no air? Obviously oxygen dependent; honey nurtures good skin also encourages slough so if he belonged to me I'd swamp in honey and vacuum seal in plastic.

Killerqueen

And the trouble with dermatologists is that they look at the dermis. What we need is an EPIDERMATOLOGIST.

Emma

I think it's just a bad case of keratosis. That's caused by genetic factors and made worse by exposure to sunlight. I have a friend who has a mild form. I used to wonder why, when he got a cut or scratch his scab would bubble up and go really hard. Usually he had to Soak it and pick it off over time and was medicated for it eventually. I know this sounds gross, try watching someone pick at it... Anyway I'm not sure what he was given but it was in the form of a pill, and he learnt to keep any cuts or grazez out of the sun so they would heal properly. He also had a lot of moles on his neck and small skin tags like this guy.
I do wonder how people like this go for so long left untreated. Medical universities do deal with unusual conditions as much as they can.

Oh and someone commented about why his family didn't cut them off. I think if it wasn't done carefully and the cut areas kept out of UV light til they were healed, this would do more harm than good. Just from what I know.

Tony Mantana

he look like he dip his hand and feet in KFC frying pan. thats horrible, I would kill my self if theres no cure.

StephenStoneMD

This really doesn't look like epidermodysplasia verucciformis, but the patient needs at least a few skin biopsies... otherwise it's all speculation.

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