Abstract Number: 173

Acquired epidermodysplasia verruciformis associated with HIV immunosuppression

D. Vekic , K. Cheung , P. Earls , M.J. Whitfeld

Meeting: 2013 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Epidermodysplasia verruciformis (EV) is a rare chronic disease usually attributed to genetic inheritance. In exceptionally rare case reports it has been described as an acquired disorder, arising in immunosuppressed patients including those affected with human immunodefi ciency virus (HIV), lymphoma and transplant recipients. The lesions are caused by infection of specifi c strains of human papilloma virus (HPV), mainly types 5 and 8. EV is characterised by an eruption of fl at wart-like lesions, hypopigmented macules, and thin plaques that resemble pityriasis versicolor. These lesions have oncogenic potential and can progress to squamous cell carcinoma. There are less than twenty-fi ve case reports of acquired EV cases in the literature to date. A 39 Year old HIV positive man presented with a fi ve-year history of erythematous macules and plaques; initially effecting the arms bilaterally, gradually spreading to the chest, back, groin and buttocks. In addition, he had classic verrucae on the dorsum of both hands. The rash had been unresponsive to treatment with topical steroids and anti-fungal preparations.
The eruption worsened after commencement of HAART. Other relevant history included Kaposi ’ s sarcoma treated with chemotherapy in 2001, and Hepatitis C. Biopsies of the plaques revealed a mildly acanthotic epidermis with associated parakeratosis. The basal and suprabasal keratinocytes were atypical, with abundant pale blue grey cytoplasm. HPV and P16 immunostaining was positive in the stratum corneum and superfi cial epidermis, consistent with a diagnosis of epidermodysplasia verruciformis. HPV subtyping is currently underway. After partial focal improvement with topical retinoids, oral acitretin was commenced.