Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Tree man syndrome orepidermodysplasia verruciformis(EV) is a rare inherited health condition. It causeswart-like skin growths resembling tree bark and is linked to a high risk ofskin cancer. Only about 200 cases have been identified since it was first discovered.
The bark-like growths are extremely painful and disfiguring. They can become quite large, which leads to substantial disability. Surgery can help, but the growths may come back.
This article discusses the symptoms, causes, and treatment options for tree man syndrome.
Ulet Ifansasti/ Stringer / Getty Images
Tree man syndrome is also called:Human tree diseaseLewandowsky-Lutz syndromeLutz-Lewandowsky epidermodysplasia verruciformis
Tree man syndrome is also called:
Tree Man Syndrome Symptoms
The major symptoms of tree man syndrome are growths on the skin. They generally appear on the face, neck, torso, hands, and feet.
Several types of skin problems are possible, including:
Some cases of tree man syndrome involve extremely large, hard protein growths calledkeratin. It’s the same material that makes up horns, hooves, claws, and fingernails.
All of these problems occur because EV makes you especially susceptible to thehuman papillomavirus (HPV).
10 Rare Skin Diseases
EV can be genetic or acquired. They’re classified based on causes, which involve infection with certain strains of HPV plus either a genetic mutation or a compromisedimmune system.
Genetics and Tree Man Syndrome
The genetic form of EV usually develops early in life, before age 20. Sometimes, though, it shows up as late as middle age.
About 75% of people with EV have mutations in one of two genes, which are called EVER1 and EVER2.The other 25% comprises non-genetic cases and mutations in several genes that allow for extensive HPV replication. These genes are called:
Acquired Tree Man Syndrome
Acquired EV occurs in people with compromised immune systems, which may be from:
HPV
In the United States, HPV is the most common sexually transmitted infection (STI). It can also lead to cervical, genital, and anal cancer. Avaccineexists to prevent the strains known to cause these types of cancer.
EV is related to different strains of HPV, which infect the skin. They’re called beta-HPVs. Strains known to be involved in EV are HPV types 5, 8, and 10.
So far, no vaccine exists for these strains, but researchers have called for the development of one.
Sun Exposure and Cancer RiskExposure to sunlight has been shown to increase the likelihood of EV becoming cancerous.
Sun Exposure and Cancer Risk
Exposure to sunlight has been shown to increase the likelihood of EV becoming cancerous.
How to Prevent Skin Cancer
EV is often diagnosed on sight because of its characteristic appearance. Healthcare providers may confirm the diagnosis with abiopsy, in which a small amount of tissue is removed and evaluated at a lab.
EV growths have certain characteristics that are visible under a microscope. Also, the type of HPV can generally be identified.
There is no cure for EV. However, some treatments can be successful. They include:
Protecting yourself from the sun is also important because exposure can make cancer more likely. This includes avoiding direct sunlight, wearing protective clothing, and using sunscreen.
Your healthcare team may want to change your medications if you have acquired EV after a transplant.
How Skin Cancer Is Treated
For How Long Can You Live With Tree Man Syndrome?
Tree man syndrome doesn’t shorten your life expectancy unless you have untreated cancer.The prognosis is better when the condition is diagnosed and treated early. The goal is to prevent or treat skin cancer.
Though growths can be removed, they usually come back later. Expect periodic removals as well as lifelong treatment.
Summary
Tree man syndrome, or EV is a rare condition that causes several types of skin growths, the most distinctive of which are large, painful, bark-like growths. HPV skin infections, certain genetic mutations, or compromised immune systems can cause it. EV is diagnosed on sight and possibly a tissue biopsy. Treatments include growth and tumor removal and retinoid medications. Bark-like growths may come back, requiring more surgeries. Early diagnosis and treatment lead to better outcomes.
9 Sources
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The Genetic and Rare Diseases Information Center.Epidermodysplasia verruciformis.
DermNet New Zealand Trust.Epidermodysplasia verruciformis.
Dash M.Tree man syndrome.Madridge J Intern Emerg Med. 2018; 2(2): 78-79. doi:10.18689/mjiem-1000117
Shruti S, Siraj F, Singh A, Ramesh V.Epidermodysplasia verruciformis: three case reports and a brief review.Acta Dermatovenerol Alp Pannonica Adriat. 2017;26(3):59-61. doi:10.15570/actaapa.2017.19
Centers for Disease Control and Prevention.About genital HPV infection.
Bandolin L, Borsetto D, Fussey J, et al.Beta human papillomaviruses infection and skin carcinogenesis.Rev Med Virol. 2020;30(4):e2104. doi:10.1002/rmv.2104
Moore S, Rady P, Tyring S.Acquired epidermodysplasia verruciformis: clinical presentation and treatment update.Int J Dermatol. 2022;61(11):1325-1335. doi:10.1111/ijd.15857
de Jong SJ, Imahorn E, Itin P, et al.Epidermodysplasia verruciformis: inborn errors of immunity to human beta-papillomaviruses.Front Microbiol. 2018;9:1222. doi:10.3389/fmicb.2018.01222
Dash M.Tree man syndrome.Madridge J Intern Emerg Med. 2018;2(2):78-79. doi:10.18689/mjiem-1000117
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