BI38 A rare case of acquired epidermodysplasia verruciformis

• Published in: British journal of dermatology (1951) 2024-06, Vol.191 (Supplement_1), p.i155-i155
• Main Authors: Murphy, Lisa, Leonard, Niamh, O’Gorman, Susan
• Format: Article
• Language: English
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1093/bjd/ljae090.326

Epidermodysplasia verruciformis (EV) is a rare, genetic disease characterized by an increased susceptibility to infection with specific types of human papillomavirus. These patients also have a higher likelihood of developing malignant skin tumours. We report the unusual case of a 51-year-old female patient who presented with 7-month history of tender, verrucous papules and nodules on the dorsum of both her hands. Her medical history was significant for sero­negative arthritis and diabetes mellitus, and she was being treated with methotrexate for her arthritis. She had never had lesions similar to these in the past and there was no history of a cutaneous malignancy. A biopsy from a lesion on the right elbow demonstrated epidermal acanthosis and a prominent granular layer suggestive of viral aetiology, such as EV. Acquired EV typically occurs in immunosuppressed patients such as those who have had transplants or haematological malignancies. The lesions generally appear at sun-exposed sites such as the hands and arms, as was seen in this case. Treatment options include topical treatments such as cryotherapy and fluorouracil, or oral agents such as acitretin. Photoprotection advice is also imperative. This case highlights the importance of considering EV in patients who are immunosuppressed, who present with a significant number of viral warts that are resistant to treatment.