An unusual amalgamation of plaques

Abstract

A 42-year-old woman presented with asymptomatic discrete hyperpigmented plaques over the body and face since childhood. Over time, these lesions amalgamated to form diffuse plaques over the entire forearm and lower legs, with a recent onset of pinkish firm growths over the preexisting lesions of the elbows and knees. Histopathology was suggestive of Human papillomavirus (HPV) infection. The patient's history, physical examination, and HPE were conclusive of epidermodysplasia verruciformis, which is a rare genetic disorder with defective cell-mediated immunity towards HPV. It is characterized by a persistent eruption of pityriasis versicolor-like macules, verruca-like papules, and seborrheic keratosis-like plaques with an increased tendency of cutaneous malignancies. We present this case for its atypical nature, i.e., the absence of typical pityriasis versicolor-like lesions and absence of malignant transformation.

Keywords

• epidermodysplasia verruciformis
• human papillomavirus
• malignancy-associated epidermodysplasia verruciformis