Freaky pathology of the day

Dr. Bick was kind enough to bring this to my attention. Thankfully, it was before lunch hour: Coral man has "shells" cut from his body.



Based on the reporting, it seems this is a similar condition to the "tree man of Indonesia"

So what's going on here? This is referred to by pathologists as "generalized verrucosis" - lots and lots of warts. Warts on the skin are caused by Human Papilloma Virus (HPV) infection. HPV has gotten a lot of press lately as it is also the cause of genital warts, and there is a new HPV vaccine on the market.

To put it simply, HPV causes proliferation of zones of cells in the epidermis. This is what results in the elevated lesions that are warts on skin. Usually these warts are self-limiting and can regress on their own. So what happened to the coral man and the tree man?

In the case of the "tree man", he had a corresponding immune deficiency, so the HPV infection ceased to be self limiting. His warts proliferated and proliferated, and those growths are the result of dysplastic changes in the skin which are associated with the build-up of excess keratin. These lesions, also called "actinic keratoses" produced so much keratin that they developed into "cutaneous horns" - which, if they get bad enough, can make the victim look like a coral reef or part human, part tree.

The coral man has undergone surgery and radiotherapy, and as you can see, he looks much better.

The tree man appears to have a tougher time of it, though the specialist thinks that regular doses of Vitamin A might help to overcome the immune deficiency.