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Diagnosed: First Female Case of 'Tree Man Syndrome'

Discussion in 'Pediatrics' started by Ghada Ali youssef, Feb 12, 2017.

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  1. Ghada Ali youssef

    Ghada Ali youssef Golden Member

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    An exceedingly rare and disfiguring condition with no cure, known colloquially as “Tree man syndrome,” has apparently struck its first female victim.

    Ten-year-old Sahana Khatun is beautiful by all accounts. However, since last year, bark-like warts have sprouted from her otherwise unblemished face. At the Dhaka Medical College and Hospital in Bangladesh, doctors suspect the culprit is epidermodysplasia verruciformis (EV).

    "We don't know yet if this is (one) hundred percent a 'tree man' syndrome, but it definitely is a variety of the epidermodysplasia verruciformis, disease which causes very unusual skin disorder," said Dr. Samanta Lal Sen, chief plastic surgeon at the hospital.

    EV is known as “Tree man syndrome” because of the hard, wood-like growths that appear on the skin. The condition is heritable, and people with EV typically have mutations in the EVER1 and EVER 2 genes. The mutations don’t cause the disease; however, it makes people more susceptible to infection with certian types of human papillomavirus (HPV). Once infected with HPV, patients develop warts, which may turn into malignant skin tumors in 50 percent of cases. By contrast, in people without the genetic mutations, the HVP infection may be completely benign.

    Although the condition is rare – only handful of cases have been documented – the disease can be quite severe. In the case of Dede Koswara, the Indonesian man for whom a documentary was made, the warts covered the ends of all of his extremities, weighing in over 13 pounds. Because the warts were inflexible, it all but took away Mr. Koswara’s ability to function normally. Unfortunately, the disease has no cure. Surgical removal of the warts is a temporary solution, as the warts continue to grow back.

    However, the situation for young Sahana may not be so severe, her doctors hope. Because she has minor protrusions, Dr. Lal Sen is optimistic that surgery and subsequent treatments will keep the growths at bay. In fact, her operation has already been scheduled for next week.



    In the same hospital, Abul Bajandar – a 27-year-old man afflicted with a severe form of the disease – is scheduled to be released from the hospital soon. Like Mr. Koswara, Mr. Bajandar also had debilitating wart growths on his extremities. Sixteen operations later and 11 pounds less, Mr. Bajandar may be able to use his hands and feet as before the growths started.

    Of note, Sahana’s case, if confirmed as EV, will be the first documented case of this disease appearing in a female. So far, all other cases have been male.

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