Rare Coexistence of Heck’s Disease and Epidermodysplasia Verruciformis in an 11-Year-Old Boy: A Case Report
AMAEWHULE Mary Nnenda *
Dermatology Unit, Department of Internal Medicine, Rivers State University, Nkpolu-Oroworukwo, Port Harcourt, Rivers State, Nigeria.
AMADI Ekechi Stella
Dermatology Unit, Department of Internal Medicine, Rivers State University, Nkpolu-Oroworukwo, Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Heck's disease is characterized by multiple, asymptomatic, soft papules on the oral mucosa, lips, and occasionally skin, commonly linked to Human papillomavirus HPV-13 and HPV-32. This report describes a case of a boy with coexisting Heck's disease and Epidermodysplasia Verruciformis (EDV), highlighting the clinical and histopathological findings. This study presents the case of an 11-year-old secondary school student who presented with a four-year history of recurrent, progressively generalised hypopigmented skin rashes associated with mild pruritus and photosensitivity. The lesions initially appeared on the neck and later became widespread. Histopathological examination of a skin punch biopsy revealed mild acanthosis, hyperkeratosis, and keratinocytes with blue-grey cytoplasm and perinuclear halos, consistent with EDV. After being lost to follow-up, he returned 13 months later with no clinical improvement. Subsequent management included topical tretinoin and high-SPF sunscreen, along with counseling on disease chronicity and photoprotection. This case highlights the chronic, treatment-resistant nature of EDV and underscores the importance of long-term follow-up, access to therapy, and early specialist involvement in management.
Keywords: Heck's disease, epidermodysplasia verruciformis, skin disorders, lesions