內容目錄
At the age of 35, Dede Koswara’s video went viral on the Internet. In the video, his limbs are covered with “twigs” and have lost their normal shape at all.
In the close-up picture, some mosquitoes are parked in the gaps between the “twigs” of his feet, and several flies are ramming head-on in the picture, trying to find the most suitable one on his feet. foothold.
Koswara’s “branch” hands
Image source: HLN NEWS
Before this, Coswara worked as a carpenter. And as you can see, now he is a “tree man”.
The Tree Man in real life
Indonesia in southern Asia is a place with 67.8% forest cover, in this typical tropical rainforest climate, Koswara lived a happy childhood. However, this leisurely contentment was called off when Coswara was 10 years old.
At the age of 10, Coswara accidentally injured his knee. Unlike usual, as the wound healed, some new tissue grew out of the skin on the outside of his bruised knee. These new tissues looked like flat stones and gradually spread throughout the body.
After that, as the knee wound completely healed, the vegetation on Scovara’s limbs did not stop growing. They gradually grew and joined together into sheets that looked rough from a distance. On the old bark, some new roots and branches grew.
Koswara’s facial skin
Image source: YouTube video screenshot
Coswara sought help from a local doctor to try to remove one of the larger growths, but the growth soon returned at the incision site.
Just like that, trapped in this mutated body, Koswara is completely dependent on others to complete her daily life. For this reason, he lost his original job, his wife and family separated, and he lived alone.
Koswara’s parents offered to live with him, but even with his parents’ support, he couldn’t afford the multiple surgeries.
According to the Los Angeles Times, in order to maintain a normal life, Coswara had to sign an agreement with a carnival owner to participate in the tour as a “strange tree man”, using his strange body to To win the audience’s joy, so as to obtain a certain economic income.
Fortunately, although the tour was a curious trend, it brought him the attention of the public.
9 surgeries, “rebirth”
In November 2007, a video of Coswara appeared on the Internet, and the mysterious manifestation of the condition attracted a lot of attention.
With the exploration of psychology from all walks of life, Koswara finally ushered in the dawn of medicine, and he was sent to a local hospital.
After a series of professional tests, doctors determined that Coswara had a condition known as Epidermodysplasia Verruciformis (EV / Epidermodysplasia Verruciformis), or as the saying goes The tree man disease.
Based on the available literature, this is an extremely rare inherited skin disease that causes a high prevalence of skin cancer.
Therefore, although no detailed etiology has been identified, considering that the large-scale growths on Koswara’s skin have seriously affected normal life and are in line with the indications for surgical resection, the doctors decided to treat him Perform excision surgery.
Reuters reported that in August 2018, Koswara underwent a total of nine surgeries. During the operation, the doctors removed the “twigs” that had grown wantonly on his hands and the thick tree-like skin. At the same time, the smaller growths on the head, torso and feet were removed, and the wounded area was removed.Subsequent skin grafting was performed.
It is reported that this removed 96% of the growths on Coswara’s body, weighing a total of 6 kg.
Post-operatively, Koswara’s health improved significantly, and he was even able to start using his hands and feet freely once he recovered.
Coswara surgery video file
Image source: YouTube video screenshot
Just, the good times don’t last long. The “twigs” on Koswara’s limbs quickly grew again.
The newly born vegetation is like the countless and diverse creatures in the tropical rainforest, wantonly clamoring for its sovereignty by occupying territory.
Soon, Coswara was back to being a “tree man.”
At this point, desperate Koswara went through a series of new surgeries to remove the overgrown growths.
Since major surgery in 2008, Koswara reportedly underwent three different types of surgery. The doctor told him, “for the rest of his life, he will need at least two surgeries a year to treat the new growth.”
It’s just that after each active surgery, the growing growths have repeatedly proven that this is only a temporary solution.
Hands after Coswara
Image source: YouTube video screenshot
At the same time, the Discovery Channel also funded a blood analysis for Coswara that found he lacked immunity against a yeast infection.
Local doctors then wanted to do more testing for Coswara, but for various purposes, Coswara ultimately refused to follow up.
On January 30, 2016, the 42-year-old “tree man” died at Hassan Sadikin Hospital in Bandung, Indonesia.
Behind the Treeman
According to foreign media reports, Coswara is not the only “tree man” in the world.
In January 2016, 25-year-old Abul Bajandar was also diagnosed with EV after undergoing 25 surgical procedures to remove more than 5kg of growths from his body.
Long-term surgical treatment overwhelmed him at a young age, and he chose to temporarily discontinue treatment. After treatment was interrupted, Abul Bajandar’s condition deteriorated sharply and he was told five or six more surgeries would be required to bring his condition back under control.
In June 2019, 28-year-old Abul Bajandar requested amputation due to unbearable postoperative pain.
Abul Bajandar’s hands
Source: Wikipedia
The two “tree people” didn’t end well, and in fact, it’s not uncommon for patients to suffer from EV as much as they do.
According to the available test data, they all have one thing in common: human papillomavirus (HPV) infection.
Studies have shown that the onset of EV is often associated with HPV types 5 and 8, and patients are extremely susceptible to these two HPV types.
However, according to the Journal of Virology, 80% of people with both types of HPV are asymptomatic. That is to say, infection does not mean that the patient will directly become a “tree man”.
In the pathogenesis of EV, genes actually play a more important role than viral infection.
Research has shown that the EVER1/EVER2 gene complex on human chromosome 17 can restrict the entry of viral proteins into zinc storage regions in cells, thereby limiting viral growth.
The EV patient has a PH mutation in one of the genes EVER1 or EVER2 on chromosome 17, causing its inactivation, so it cannot play a corresponding inhibitory effect on the HPV virus, resulting in Overt infection.
It is the superposition of viral infection and gene mutation that finally leads to the onset of EV.
After understanding the pathogenesis, doctors have proposed several methods for this strange disease. Currently, the most effective treatment is considered to be oral acitretin 0.5-1 mg/day for 6 months, which can achieve the purpose of anti-proliferation and induction of differentiation.
There are also related cases in China: a 36-year-old male patient with multiple growths on his limbs for 24 years, his hands, forearms, feet and calves were covered with light dark brown warty growths, wart bodies Multiple large hard skin horns formed on the surface and were diagnosed as verrucous epidermal dysplasia. After the combination of Avi A capsules and radiation therapy, the rash basically subsided.
The use of another drug, cimetidine, is highly controversial. In fact, until now, 4 years after Koswara’s death, the medical community has not yet had a very clear conclusion on the treatment of EV.
Only, one thing is certain: although the effect of drug treatment is not obvious, early diagnosis and good patient education, timely removal of the lesion area according to the needs, are all measures to prevent the development of skin effective way to treat tumors.
In the context of exploratory therapy, it is important to know that the people who grow “twigs” are not “tree people”, but a small group of patients who need attention group.
This article is reproduced from Lilac Garden, please contact the first public account for reprinting.
References
1.”The man who looks like a tree”. Metro. 22 November 2007.
2.”Half Man Half Tree”. Discovery Channel. Archived from the original on 1 September 2008.
3.””Tree Man” Medical Mystery”. ABC News. 15 August 2008.
4.”Indonesia’s “tree man” comes home after treatment”. Los Angeles Times. 2014-09-16.
5.”‘Tree man’s’ warts growing again | The Australian”. web.archive.org. 2009-09-12.
6. Ramoz N, Rueda LA, Bouadjar B, Montoya LS, Orth G, Favre M (December 2002). “Mutations in two adjacent novel genes are associated with epidermodysplasia verruciformis”. Nature Genetics . 32 (4): 579C81. doi: 10.1038/ng1044. PMID 12426567. S2CID 20013445.
7. Lazarczyk M, Pons C, Mendoza JA, Cassonnet P, Jacob Y, Favre M (January 2008). “Regulation of cellular zinc balance as a potential mechanism of EVER-mediated protection against pathogenesis by cutaneous oncogenic human papillomaviruses”. The Journal of Experimental Medicine. 205 (1): 35C42. doi:10.1084/jem.20071311. PMC 2234378. PMID 18158319.
8. Orth G (1986). “Epidermodysplasia verruciformis: a model for understanding the oncogenicity of human papillomaviruses”. Ciba Foundation Symposium. Novartis Foundation Symposia. 120:157C74.doi:10.1002/9780470513309 .ch11.ISBN 9780470513309. PMID 3013521.
9. Antonsson A, Forslund O, Ekberg H, Sterner G, Hansson BG (December 2000). “The ubiquity and impressive genomic diversity of human skin papillomaviruses suggest a commensalic nature of these viruses” .Journal of Virology.74(24):11636C41.doi:10.1128/JVI.74.24.11636-11641.2000.PMC 112445.PMID 11090162.
10. Gül U, Kili A, G nül M, Cakmak SK, Bayis SS (October 2007). “Clinical aspects of epidermodysplasia verruciformis and review of the literature”. International Journal of Dermatology. 46(10):1069C72.doi:10.1111/j.1365-4632.2006.03014.x. PMID 17910717.
11. “Now I am well, says Bangladeshi Tree Man”.
12.”Hope for Bangladesh ‘Tree Man’ after 16 surgeries to remove growths”. Al Arabiya. AFP. 10 January 2017.
13. “‘Big mistake for me to leave’: Man’s ‘tree man’ condition returns worse than before after interrupting treatments”.
14.”Bangladesh ‘Tree Man’ wants hands amputated”. Gulf News.
Planning
Planning: carollero, Xintongtong | Producer: gyouza
Cover image source: Wikipedia
This article has been professionally reviewed by Chen Jiaqi, Chief Physician, Department of Dermatology, Second Affiliated Hospital of Zhejiang University School of Medicine, and Wu Daxing, Deputy Chief Physician, Tongxiang Dermatology Prevention and Treatment Institute
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