Samia Nugali

King Saud Medical City, KSA

Title: Epidermodysplasia verruciformis


Samia Nugali took her Bachelor certificate from King Saud University in medicine and general surgery in 1987 from Riyadh, Saudi Arabia and Internship in 1988. In 1989, I joined ministry of health and worked as general doctor for a year and half. In 1991, I joined King Saud medical city and the Saudi council, in 1998 passed both parts I and II of Arab board. Presently she works as specialist doctor with experience for more than 25 years in dermatology department. Now she is an associate consultant in King Saud Medical City.


Background: EV or Epidermodysplasia verruciformis is a genodermatosis marked by vulnerability to epidermoysplasia verruciformis-human papillomavirus infections leading to initial development of disseminated flat wart-like and pityriasis versicior-like lesions. Lewandowski ad Lutz first described the disease. Nearly half of all patients having EV would develop
cutaneous malignancies, leading to Bowen’s type carcinoma (invasive) and squamous cell carcinomas insitu which happen mostly on sun-exposed areas in the forties of fifties.
Statement of the Problem: A Saudi male of 55 years came to the clinic with a chief complaint of growth extending from his toe nail. He had this growth since one year and it was growing in size. The growth was painless and it extended from the hard long toe nail . Required investigations were carried out including complete blood count, LFT, ESR and skin biopsy. And a final diagnosis of EPIDERMO DYSPLASIA VERRUCIFORMIS was confirmed. Surgical treatment is substantially quite effective. The preferred approaches include defect reconstruction with full-thickness or split-thickness grafts, complete excision or localflaps. The chemotherapy without or with radiotherapy, as in our case can be beneficial in achieving tumor’s regression/lymph nodes before surgery. Mohs micrographic surgery can preserve the healthy tissues, which are important for these patients afflicted by multiple skin cancers and having risk of their recurrence. Another alternative option is the non-surgical treatment.
Different types of non-surgical treatment methods are tried for treatment of EV, such as oral as well as topical retinoids, immunotherapy, interferon, cryotherapy and electro-desiccation. EV is essentially a genetic cancer and is of viral origin, and might also be considered as a model of cutaneous HPV oncognesis
Conclusion & Significance: EV is essentially a genetic cancer and is of viral origin, and might also be considered as a model of cutaneous HPV oncognesis. Generally, EV reveals an autosomal receding pattern of inheritance. Lengthy exposure to sunlight not using sunscreens, living in high altitudes and outdoor occupations all these cause malignant deterioration of EV lesions.