Association of cutaneous malignancy with epidermodysplasia verruciformis: a clinicopathological study

Asma Khalid, Rushqia Mukhtar, Syed Afaq Ahmed


Objective To find out presence of nonmelanoma skin cancer (NMSC) in a series of 13 patients with diagnosis of epidermodysplasia verruciformis (EDV).


Methods This prospective descriptive study detailed the clinical presentation of patients with EDV associated with nonmelanoma cutaneous malignancy between 2007 and 2010 presenting to Dermatology OPD Pakistan Institute of Medical Sciences, Islamabad. Patients were diagnosed on clinical basis. Patients with all ages and both sexes were included. Skin biopsies were taken from lesions with suspicion of malignancy, stained with hematoxylin and eosin and studied in collaboration with histopathologist. Different histopathological findings were recorded and results analyzed.


Results 13 cases were studied for presence of NMSC. NMSC were found in 3 (23%) out of 13 patients. Actinic keratosis was found in 2 patients and one patient had seborrheic keratosis with suspicious lesions.


Conclusion The clinically suspicious lesions should always be biopsied, as cutaneous malignancy is a well-known, frequent and serious complication of EDV and there is high potential in these patients to develop premalignant conditions.



Actinic keratosis, epidermodysplasia verruciformis, seborrheic keratosis, squamous cell carcinoma

Full Text:



Vohra S, Sharma NL, Shanker V et al. Autosomal dominant epidermodysplasia verruciformis: A clinicotherapeutic experience in two cases. Int J Dermatol. 2010;76:557-61.

Bhutoria B, Shome K, Ghosh S et al. Lewandowsky and Lutz dysplasia: Report of two cases in a family. Int J Dermatol. 2011;56:190-3.

Majewski S, Jablonska S. Epidermodysplasia verruciformis as a model of human papillomavirus-induced genetic cancer of the skin. Arch Dermatol. 1995;131:1312-18.

Zhu D, Fang H, Qiao J et al. Giant warts in a Chinese with epidermodysplasia verruciformis. Int J Dermatol. 2011;77:730.

Majewski S, Jablonska S. Do Epidermodysplasia verruciformis human papillomaviruses contribute to malignant and benign epidermal proliferations? Arch Dermatol. 2002;138:649-54.

Ramesh A, Krishnan SGS, Jayaraman M, Janaki VR. Epidermodysplasia verruciformis. Indian J Dermatol Venereol Leprol. 1997;63:238-40.

Landini MM, Zavattaro E, Borgogna C et al. Lack of EVER2 protein in two epidermodysplasia verruciformis patients with skin cancer presenting previously unreported homozygous genetic deletions in the EVER2 gene. J Invest Dermatol. 2011;132:1305-8.

Michael KM, Waterboer T, Pfister H et al. Seroreactivity of 38 human papillomavirus types in epidermodysplasia verruciformis patients, relatives, and controls. J Invest Dermatol. 2010;130:841-8.

Oste VD, Azzimonti B, Andrea MD et al. High β-HPV DNA loads and strong seroreactivity are present in epidermodysplasia verruciformis. J Invest Dermatol. 2009;129:1026-34.

Bari AU, Yasmin R, Ahmed A. Epidermodysplasia verruciformis: a rare genodermatosis with risk of malignant transformation. J Pak Assoc Dermatol. 2006;16:243-6.

Jenny V, Genevieve W, Rajendra S et al. Common variable immunodeficiency syndrome associated with epidermodysplasia verruciformis. Clin Dermatol. 2007;8:307-10.

Padlewska K, Ramoz N, Cassonnet P et al. Mutation and abnormal expression of the p53 gene in the viral skin carcinogenesis of epidermodysplasia verruciformis. J Invest Dermatol. 2001;117:935-42.

De Oliveira WR, Rady PL, Grady J et al. Polymorphisms of the interleukin 10 gene promoter in patients from Brazil with epidermodysplasia verruciformis. J Am Acad Dermatol. 2003;49:639-43.

Orth G, Favre M, Majewski S, Jablonska S. Epidermodysplasia verruciformis defines a subset of cutaneous human papillomaviruses. J Virol. 2001;75:4952-3.

Orth G. Human papillomaviruses associated with epidermodysplasia verruciformis in non-melanoma skin cancers: guilty or innocent? J Invest Dermatol. 2005;125:12-3.

Gül U, Kılıç A, Gönül M et al. Clinical aspects of epidermodysplasia verruciformis and review of the literature. Int J Dermatol. 2007;46:1069-72.

Robati RM, Marefat A, Saeedi M et al. Four familial cases of epidermodysplasia verruciformis: Mother and three sons. Dermatol Online J. 2009;5:8.

Majewski S, Jablonska S. Current views on the role of human papillomaviruses in cutaneous oncogenesis. Int J Dermatol. 2006;45:192-6.

Jacy WK, Villiers EMD. Epidermodysplasia verruciformis in Africans. Int J Dermatol. 1993;32:806-10.

Sharma KV, Kaur S, Kumar B, Sehgal S. Epidermodysplasia verruciformis with squamous cell carcinoma in a Family. Indian J Dermatol Venereol Leprol. 1985;51:80-6.


  • There are currently no refbacks.

ISSN: 1560-9014