Abul Bajandar (the tree man) is a pedicab driver from Bangladesh who suffers from a rare condition – verruciform epidermodysplasia – that causes scabs to appear on his hands and feet similar to tree bark. For this condition, he became well known worldwide in 2016 and earned the nickname “tree man.”
In statements given to the press, Abul Bajandar said that he began to notice warts growing on one of his legs when he was 15 years old. At first, they looked small and he thought they were harmless. However, over the years they grew considerably until their hands were rendered useless.
Due to his illness, he had to quit his job. Her scabs had grown in such a way that it hurt to move her limbs and there came a time when she needed constant care from her mother and wife.
So he went to India seeking some kind of care for his illness. There they told him that the surgery cost 5,800 euros. Abul Bajandar and his family were poor, so they could not afford that expense. Fortunately for him, the largest public hospital in Bangladesh offered to operate on him free of charge and admitted him in 2016 for surgery.
Abul Bajandar was born in 1990 in a small rural town called Payikgachha, in the Khulna district of Bangladesh. There is not much information from the time before he suffered from the disease that made him famous as the “tree man.” However, it is known that he met his wife, Halima Khatun, before the disease became massive.
Halima married against the will of her parents, who were concerned about her future if she married someone with the disease. However, the marriage took place and soon after they had a girl who was born apparently healthy.
To earn a living, Bajandar worked as a taxi bike operator in his hometown. As his deformity in his hands and feet progressed, curiosity and mockery around him increased, and it became more difficult to perform his job. In the end he had to leave it and was unemployed.
In 2006, the Dhaka Medical College hospital entered Abul Bajandar for surgery. During his treatment he underwent around 24 operations to remove about 5 kilograms of warts from his hands and feet. This forced him to live with his wife and daughter in a hospital room for a year.
Subsequently, in 2018, the world’s newspapers have begun to report that the warts on Abul’s hands have started to appear again, which has worried the doctors who treated him for the first time, since they thought that they never would return. Currently, a world board of specialists is dealing with this case.
Disease (verruciform epidermodysplasia)
Verruciform epidermodysplasia (VE) is an autosomal recessive hereditary skin disorder (2 copies of the abnormal gene are present), characterized by eruptions of warty lesions that can appear anywhere on the body, caused by infection with the human papillomavirus (HPV). ).
According to medical research, there are more than 70 subtypes of HPV that are responsible for causing a wide range of viral warts. In most of the population, infection with some subtypes of HPV has a clinically unappreciable effect. However, infection with these same subtypes can cause wart-like lesions.
A great concern for physicians in relation to patients with EV is that warty lesions can transform into skin cancer. Exposure to sunlight or UV rays has been shown to be involved in the progressive mutation of benign warts or warts to malignant skin cancers.
Furthermore, it has been found that the possibility of EV lesions turning into cancers depends on the type of HPV infection that the patient presents. More than 90% of EV-related skin cancers contain HPV types 5, 8, 10, and 47. EV lesions caused by HPV 14, 20, 21, and 25 are generally benign skin lesions.
EV is an inherited autosomal recessive disorder, so it needs 2 abnormal EV genes (one from each parent) to manifest. Specialists have found that 10% of EV patients come from marriages between consanguineous relatives (the parents have a common ancestor).
Approximately 7.5% of cases appear in childhood, 61.5% in children between 5 and 11 years old and 22.5% in puberty, affecting both men and women and people of all races.
Clinical characteristics of epidermodysplasia verruciformis
According to the clinical records of known cases, there are two types of EV lesions. The first of these corresponds to flat lesions, which can be papules (small eruptive tumors of the skin) with a flat surface and in colors ranging from pale pink to violet.
In some places, the papules may coalesce to form large plaques, which may be reddish-brown in color and have scaly surfaces and uneven edges, but may also be hypopigmented or hyperpigmented.
These flat lesions commonly appear on areas exposed to the sun , such as the hands, feet, face, and earlobes. By transforming into plaque-like lesions, they usually appear on the trunk, neck, arms, and legs. The palms, soles, armpits, and external genitalia may also be involved.
The second type of EV lesions corresponds to warty or seborrheic lesions, similar to keratosis. They are also seen most often on skin exposed to the sun. Also, they are very frequently slightly raised brown lesions. Mostly, they appear in groups from a few to more than a hundred.
All medical sources agree that EV is a lifelong disease. Although lesions can be treated or removed as they appear, patients with EV will continue to develop these lesions throughout life. In many cases, the lesions can develop and remain unchanged for years.
Also, the greatest risk faced by EV patients is that in 30-60% of cases, these lesions can change into skin cancers. These cancers are mainly squamous cell carcinoma and intraepidermal carcinoma. Malignant tumors are usually found in patients 30 to 50 years of age.
Currently, there is no treatment to prevent the appearance of EV lesions. Management of these injuries involves a combination of medical and surgical treatments. In parallel, doctors recommend patient counseling, education, and regular monitoring.
On the other hand, studies recommend that sun protection strategies should be followed, especially if you live at high altitudes or work outdoors. Exposure to sunlight (UVB and UVA) has been shown to increase the rate of EV lesions that develop into skin cancers.
- Information. (2016, February 25). Abul Bajandar, the incredible ‘tree man’ who amazes Bangladesh and the world. Taken from lainformacion.com.
- Hodge, M. (2018, January 29). Root of the problem ‘Tree man’ of Bangladesh’s dismay as painful bark-like warts start REGROWING on his hands just months after surgery to remove 5kg growths. Taken from thesun.co.uk.
- The Guardian. (2017, January 06). ‘Tree man’ Abul Bajandar regains use of his hands after groundbreaking surgery. Taken from theguardian.com.
- Samaa. (2018, February 03). After 24 surgeries, Bangladesh’s ‘Tree man’ has bark-like growths again. Taken from samaa.tv.
- Pokharel, S. and Willingham, AJ (2017, January 10). Bangladesh’s ‘Tree man’ has his hands back. Taken from edition.cnn.com.
- Ngan, V. (2016). Epidermodysplasia verruciformis. Taken from dermnetnz.org.