Work

Unusual Presentation of Epidermodysplasia Verruciformis (EV) in Non‐Sun Exposed Area: A Case Report

Year: 2025

Type: article

Abstract: Introduction and Importance: Epidermodysplasia verruciformis (EV), a rare hereditary skin disorder linked to HPV immunity, increases the risk of squamous cell carcinoma (SCC), typically in sun‐exposed areas. This case highlights an extraordinary instance of SCC in a Sun‐shielded region, marking the second documented case globally. Methods: The medical records and histopathological slides of the case were retrospectively reviewed. This work has been reported based on the CARE criteria. Case Presentation: A 28‐year‐old Palestinian woman, who adheres to a sun‐protective Hijab due to her Muslim faith and has limited sun exposure working in a clothing store, with painful scalp lesions presented at the dermatology clinic. She and her siblings were diagnosed with EV. Three years ago, a painful, enlarging lesion on her scalp led to a diagnosis of trichoblastic carcinoma, followed by the development of six similar lesions. A year later, she returned with multiple painful, pus‐producing lesions exhibiting features of trichoblastic and verrucous carcinoma, posing a challenging clinical scenario. Clinical Discussion: EV is a rare genetic skin disorder linked to EVER1/TCM6 or EVER2/TCM8 gene mutations, causing widespread warts due to specific HPV types. It heightens the risk of nonmelanoma skin cancer (NMSC), mainly SCC, often associated with beta‐HPVs 5 and 8. Notably, atypical cases challenge the sun‐exposure SCC concept. The reatment involves UV protection, retinoids, and close monitoring, critical to prevent lesion recurrence and aggressive malignancy interventions upon therapy discontinuation. Conclusion: In this unique case, a patient with EV developed SCC in an uncommonly sun‐protected skin area, highlighting the extreme rarity of such an event within the context of this condition’s complications.

Source: Case Reports in Dermatological Medicine

DOI: 10.1155/crdm/7801944