Epidermodysplasia Verruciformis misdiagnosed as Pityriasis Versicolor

Epidermodysplasia verruciformis is an inherited autosomal recessive disorder characterized by widespread and persistent infection with HPV commonly HPV3 and 10, giving rise to a characteristic combination of plane warts, pityriasis versicolor like lesions and reddish plaques like lichen planus. It is an autosomal recessive condition though autosomal dominant and X- linked dominant cases has also been reported. In EV, there are mutations in the EVER1 or EVER2 genes on chromosome 17q25, which, due to a defect of cell-mediated immunity, lead to an abnormal susceptibility of the patients to a specific group of HPV genotypes known as EV HPV. The disease usually begins in childhood with equal prevalence in both sexes affecting persons of all races. Malignant changes like squamous cell carcinoma, basal cell carcinoma occurs in 30- 70% of cases on the sun exposed parts in the age group 20-40 years, but metastasis is rare. EV diagnosis must be suspected when persistent verrucas are present in large body areas and are thus difficult to treat. We report a case of a 20 years old male patient who came to our OPD with the complaints of asymptomatic white patches over upper chest, upper back, B/L upper limb & neck since 1½ year.