Diseases

Tree Man
A 27-year-old man in Bangladesh known as the "tree man" recently underwent surgery to remove
the extensive, wood-like warts that covered his hands and feet. But what causes this rare disease?
Over the past year, the man, Abul Bajandar, has undergone 16 surgeries to remove 11 lbs. (5
kilograms) of the unusual growths from his hands and feet, according toAgence France-Presse
(AFP).
Prior to the surgery, the growths were so extensive that Bajandar could not feed himself or hold
his daughter.
"Now I feel so much better; I can hold my daughter in my lap and play with her," Bajandar told
AFP. Bajandar has a rare genetic condition called epidermodysplasia verruciformis, according
to news reports. People with this condition are more susceptible to human papillomavirus
(HPV)infections in their skin, according to a 2010 report of the condition.
 In people with this condition, HPV infections lead to the formation of wart-like skin
lesions, which progress to malignant tumors in about 50 percent of patients, the report said. In
people without this condition, infections with the same HPV strains may not cause any
symptoms, according to Medscape.
People with epidermodysplasia verruciformis typically have mutations in two genes,
called EVER1 and EVER2. It's not exactly clear how these gene mutations lead to the
condition, but it's thought that these mutations make the body less able to ward off HPV
infections.
Bajandar's warts first appeared on his hands and feet when he was in his teens, and the
growths began to multiply rapidly in his early 20s, according to The Washington Post.
In 2016, doctors at Dhaka Medical College and Hospital in Bangladesh performed the 16
surgeries, and Bajandar is expected to leave the hospital within the next 30 days, according to
the AFP report.
 It's not clear if Bajandar is cured of his condition; his warts could grow back, the AFP
report said.
Currently, there is no definitive cure for epidermodysplasia verruciformis, according to
the 2010 paper.
"Finding ways to address skin lesions in epidermodysplasia verruciformis patients is a
constant struggle," the paper said.
In addition to surgery, treatment can include drugs called retinoids, which can curb cell
growth and are sometimes used to treat skin conditions; and interferon, a protein produced by
the body to fight viruses.
However, "though there are a plethora of [treatment] options, none seem to be curative,
and lesions usually recur after treatment cessation," the paper said.
 Proteus syndrome 

Proteus syndrome is a rare disorder with a genetic background that can cause tissue overgrowth
involving all three embryonic lineages. Patients with Proteus syndrome tend to have an increased
risk of embryonic tumor development. The clinical and radiographic manifestations of Proteus
syndrome are highly variable. Yet, the orthopedic manifestations of the syndrome are unique.
The syndrome is named after the Greek sea-god Proteus, who could change his shape. The
condition appears to have been first described in the American medical literature by Samia
Temtamy and John Rogers in 1976. Michael Cohen described it in 1979.  Only a few more than
200 cases have been confirmed worldwide, with estimates that about 120 people are currently
alive with the condition. As attenuated forms of the disease may exist, there could be many people
with Proteus syndrome who remain undiagnosed. Those most readily diagnosed are also the most
severely disfigured.
 In childhood, affected individuals may develop abnormal skin conditions including
localized areas of severe fatty overgrowth especially affecting the stomach or the arms and
legs. In some, benign tumors consisting of fatty tissue (lipomas) may develop. In addition to
fatty tissue overgrowth, some affected individuals may develop areas of fatty tissue loss
(atrophy) especially in the chest.
Affected children may also develop a raised, rough (verrucous) lesion (epidermal nevus)
that is usually rough and dark brown or brownish-black. An epidermal nevus may be present
at birth. Another skin lesion known cerebriform connective tissue nevus may occur. This
slow-growing lesion is most often found on the feet and less commonly on the hands. It is not
present at birth and is made up of thickened, abnormally firm subcutaneous tissue. The skin
may develop deep grooves or furrows.