Lewandowski-Lutz verruciform epidermodysplasia

Verrushiform epidermodysplasia of Lewandowski-Lutz (blue verrucosis generalisata) is a rare disease, in some cases familial. Assumed autosomal recessive or X-linked inheritance. It usually occurs in childhood, it is manifested by common, mostly warty rashes, which have some peculiarities depending on localization. So, on the face and neck they are similar to flat warts, on the limbs, especially on the distal parts. Have the appearance of ordinary warts with a tendency to group, strip-like arrangement, fusion with the formation of large warty foci. The trunk is dominated by flat, sharply outlined plaques and foci resembling pityriasis. The color of the elements varies from the color of normal skin to pinkish-red, reddish-brown. Unlike other types of warts that disappear spontaneously for several months or years, verruxiform epidermoliplasia has a permanent course, with a high risk of malignant transformation mainly in foci located on exposed parts of the body.

Pathomorphology. The picture resembles that of a flat juvenile wart. Acanthosis with thickening of epidermal processes and hyperkeratosis are noted. However, the vacuolization of the cells of the upper parts of the epidermis is more pronounced, the vacuoles are much larger, which is characteristic of this disease. In the derma, no special changes are detected

Histogenesis. Warts with verruziforme epidermodysplasia are caused by various types of human papillomavirus, but mostly viruses 3, 5 and 8 types. Several types of virus are often found in the same patient, but there are cases of isolating only one of them. Various disorders of cellular immunity, mainly a decrease in the number and inhibition of T-helper function, were detected, but this is not observed in all patients. The most oncogenic viruses are HPV-5, HPV-8 and HPV-14.