Epidermodysplasia verruciformis in Nigerians

Abstract

An analysis of the clinical and pathologic characteristics of 12 Nigerian patients with epidermodysplasia verruciformis (EV) is presented. Two morphological variants have been observed, typical wart-like flat-topped papules and larger confluent plaques. Seborrhoeic keratoses were observed in patients with the second morphological variety of EV. Solar elastosis was found in biopsies taken from EV lesions in this subgroup of patients. A particular rarity of seborrhoeic keratosis in Africans is emphasized as no single African case of seborrhoeic keratosis was found apart from patients with EV. No malignant epithelial skin tumours were found in the whole group. Factors underlying an apparently more benign course of EV in Africans are discussed, and the literature on EV in Africa is reviewed.

Acquired epidermodysplasia verruciformis

“…One study of 12 black Nigerian patients with EV found no cutaneous malignancies at the time of examination. 26 The patients' ages ranged from 9 to 40 years, but only two cases occurred in patients over the age of 24 years. In white individuals with EV, malignant transformation occurs in the fourth decade of life; therefore, it is difficult to conclude if increased pigment is protective without an older patient population for comparison.…”

Epidermodysplasia verruciformis in Lepromatous Leprosy

“…Jacyk and Subbuswamy [8] found 12 cases in a period of 4 years in Nigeria, and Schaller [13] sees the condi tion with unexpected frequency in Togo. Finding of a widespread wart infection in 2 sisters with LL leprosy, a condition often found to demonstrate a generalized impair ment of cell-mediated responsivity towards antigens other than those of Mycobacterium leprae, raises the question of the competence of the lepromatous patient in resisting other infections.…”

“…It would be of interest to know the frequency of HPVs infections in leprosy and whether its lepromatous form presents an additional ex ample of immunodeficiency predisposing towards EV. The question of the apparent benignancy of EV in Africans has been dis cussed [8],…”

Seborrheic Keratosis‐like Lesions in Patients with Epidermodysplasia Verruciformis

“…The malignant form of EV is highly polymorphic; SK-like lesions have been reported in a few series of patients, most comprised of black individuals (12)(13)(14) .…”

“…The malignant tumors that develop are locally destructive with low metatastic potential, unless co-carcinogenes such as X-ray irradiation or intense and prolonged ultraviolet exposition are involved (5). Seborrheic-keratosis-like (SK) lesions have also been reported in EV patients, predominantly in black individuals; they include pigmented and hyperkeratotic papules and plaques and are possibly associated with the malignant phenotype of EV (12)(13)(14).…”