Dermoscopy in Epidermodysplasia Verruciformis

BACKGROUND: Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genodermatosis characterized by an impairment of cellular immunity. It clinically manifests as widespread, long-lasting, pityriasis versicolor-like macules and flat, wart-like papules, usually occurring in early childhood. There is a risk of development of multiple skin cancers in the third decade, primarily in sun-exposed skin. EV-associated human papillomaviruses have been implicated in a number of cutaneous lesions in non-EV populations, such as seborrheic keratoses or psoriasis. They have also been implicated in the development of nonmelanoma skin cancer, especially in immunosuppressed patients. Patients affected with EV are not able to eliminate oncogenic viruses within lesions, leading to a malignant transformation. OBJECTIVE: To describe the dermoscopic characteristics of EV cutaneous tumors by performing histopathologic correlation. METHODS AND MATERIALS: Cutaneous lesions and tumors from two patients affected by EV were included. Clinical and dermoscopic images were obtained and excision with ulterior histopathology was performed in all suspicious tumors and characteristic lesions. RESULTS: Dermoscopy and histology of pityiriasis versicolor-like macules, wart-like papules, seborrheic keratosis-like tumors, psoriasis-like plaques, collision tumors, and Bowen in situ carcinoma are described. CONCLUSIONS: Dermoscopy in EV tumors correlated with histopathologic findings and improved the differential diagnosis of tumors in this disease.