The Tree Man Disease

You probably know Treebeard from J.R.R. Tolkien "the Lord of the Rings" trilogy as below:

But we are not in the Middle Earth, having a walk with some Ents and Hobbits. The Tree Man disease is actually a real disease, scientifically named Epidermodysplasia verruciformis.

Epidermodysplasia verruciformis:

This skin disorder is a lifelong, hereditary and extremely rare disease, only 195 cases have been documented in the scientific literature. It is due to an immunodeficiency causing an atypical skin disorder, more or less severe. The immunodeficiency allows human Papillomaviruses, naturally present on our skin but in an asymptomatic way, to develop themselves on the sick person's skin.

Diagnosis:

There are 3 different levels of skin eruption : 

1. scaly macules: a change of skin color, white or red
2. papules: a solid elevation of skin
3. cuteneous carcinoma: the most common skin cancer

There are generally present all over the body, but it also can be concentrated on the most exposed to the sun parts of the body, like face and hands.

Treatment:

Any treatment has not been found yet. Some physicians have proposed several treatments, already used in other skin disorders, but none of them is actually working. Tumoral lesions can be removed in early stages of development, to avoid metastasic cancer. Prevention and patient education can also minimize severe effects of the disease.

Notable case:

Dede Koswara, a 39-year-old Indonesian man has a severe stage of Epidermodysplasia verruciformis. In 2007 and 2008, Discorvery Channel and ABC made documentaries on his disease, and nicknamed him the Tree Man. 

As you can see, his hands and feet are very impressive. It is like he had bark on his skin. In August 2008, he decided to have a surgery to remove all the warts he had on his body. In the end, 6 kg have been removed, ie 95% of all warts.

 

Unfortunately, in a couple of months, his warts have grown back. He would need two surgeries a year for the rest of his life to have a almost normal skin. He is still alive and had another surgery in spring 2011.