Epidermodysplasia verruciformis (EV) is a rare skin disease due to persistent human papilloma virus (HPV) infection. 1 Multiple cancerous lesions develop after middle age. EV lesions are resistant to interferon and immunotherapy, and require surgical treatment with skin grafts. 2 The numbers of cancerous lesions increase annually, while donor sites for normal skin diminish. Banking of cultured epidermal sheets may resolve this problem.

A 50-year-old woman with EV complained of enlargement of Bowenoid cancer lesions on her face and forehead. Multiple lesions did not respond to intralesional interferon-α, interferon-γ, or bleomycin. Because she had had multiple surgical treatments, areas with normal skin suitable for grafting were limited. Two cm2 of clinically normal skin distant from the Bowenoid cancers and warts was harvested after obtaining informed consent. Keratinocytes were cultured from the specimen3 and prepared as epidermal sheets. Multiple facial cancerous lesions were removed surgically. The raw surfaces where the tumours had been excised and split thickness skin graft donor site were covered with the cultured epidermal sheets using a fibrin adhesive. The sheets had adapted completely within a week. Grafted skin was amelanotic but there was no apparent recurrence of verrucous lesion observed during a 3-year follow-up.