Rare Coexistence of Heck’s Disease and Epidermodysplasia Verruciformis in an 11-Year-Old Boy: A Case Report

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.