Fir tree man shocks doctors

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Tree Man syndrome Epidermodysplasia verruciformis

Epidermodysplasia verruciformis (also called Lewandowsky-Lutz dysplasia or Lutz-Lewandowsky epidermodysplasia verruciformis) is an extremely rare autosomal recessive genetic hereditary skin disorder associated with a high risk of carcinoma of the skin. It is characterized by abnormal susceptibility to human papillomaviruses (HPVs) of the skin. The resulting uncontrolled HPV infections result in the growth of scaly macules and papules, particularly on the hands and feet. It is typically associated with HPV types 5 and 8 which are found in about 80% of the normal population as asymptomatic infections, although other types may also contribute.
The condition usually has an onset of between the ages of 1–20, but can occasionally present in middle-age. It is named after the physicians who first documented it, Felix Lewandowsky and Wilhelm Lutz.

Genetic cause
The cause of the condition is an inactivating HP mutation in either the EVER1 or EVER2 genes, which are located adjacent to one another on chromosome 17. The precise function of these genes is not yet fully understood, but they play a role in regulating the distribution of zinc in the cell nucleus. It has been shown that zinc is a necessary cofactor for many viral proteins, and that the activity of EVER1/EVER2 complex appears to restrict the access of viral proteins to cellular zinc stores, limiting their growth.
Clinical diagnostic features are lifelong eruption of pityriasis versicolor-like macules, flat wart-like papules and development of cutaneous carcinomas.
Patients present with flat, slightly scaly, red-brown macules on the face, neck and body, recurring especially around the penial area, or verruca-like papillomatous lesions, seborrheic keratosis-like lesions, and pinkish-red plane papules on the hands, upper and lower extremities, and face. The benign form of EV presents with only flat, wart-like lesions over the body, whereas the malignant form shows a higher rate of polymorphic skin lesions and development of multiple cutaneoustumors.
Generally, cutaneous lesions are disseminated over the body, but there are some cases with only a few lesions which are limited to one extremity.

A totally effective treatment method against EV has not yet been found. Several treatments have been suggested, and acitretin 0.5–1 mg/day for 6 months’ duration is the most effective treatment owing to antiproliferative and differentiation-inducing effects.
Interferons can also be used effectively together with retinoids.
Cimetidine was reported to be effective because of its depressing mitogen-induced lymphocyte proliferation and Regulatory T cell activity features. A report by Oliveira et al. showed that cimetidine was ineffective. Hayashi et al. applied topicalcalcipotriol to a patient with a successful result.
As mentioned, various treatment methods are offered against EV; however, most importantly, education of the patient, early diagnosis and excision of the tumoral lesions take preference to prevent the development of cutaneous tumors.

Close-up of Hand
Notable cases
In March 2007, a Romanian man named Ion Toader was diagnosed with this condition. A patient of dermatologist Carmen Madeleine Curea, his pictures appeared on numerous blogs and Romanian press sources. Curea works with Spitalul Clinic Colentina in Bucharest, Romania. Stephen Stone, past president of the American Academy of Dermatology, confirms this is Lewandowsky-Lutz
In November 2007, a new video of a 34-year-old Indonesian man named Dede Koswara with a similar disease appeared on the internet. His story has appeared in the Discovery Channel and TLC series “My Shocking Story” (Extraordinary People on UK’s Five) in the episode “Half Man Half Tree”. And then on August 12, 2008, Dede Koswara’s story was the subject of an ABC’s Medical Mystery episode entitled “Tree Man”.
On 26 August 2008, Dede returned home following surgery to remove 6 kg (13 lb) of warts from his body.[13] The surgery consisted of three steps:
 Removal of the thick carpet of warts and massive horns on his hand.
 Removal of the smaller warts on his head, torso, and feet.
 Covering of the hands with grafted skin.

Dede Koswara
In all, 95% of the warts were removed. The surgery was documented by the Discovery Channel and TLC in the episode “Treeman: Search for the Cure.” However, his warts have returned and it appears he will need two surgeries a year for the rest of his life to keep them at bay. The Discovery Channel funded a blood analysis and found he lacked an immune system antigen to fight yeast infection. He was offered to have more tests run to determine whether it is treatable, and the doctor was fairly optimistic, but he refused the treatment.
In 2009, the Discovery Channel episode “Treeman Meets Treeman” reported on another Indonesian man, from the same region as Dede, who also has the disease and was given a similar treatment for it. Thus far, his treatment seems to have worked better.

Dede’s Hand
According to The Jakarta Post, Dede underwent the first of a series of new surgical procedures to remove the regrown warts in the spring of 2011. Surgery has, however, proven to be a temporary solution for Dede as the warts continue to reemerge. He has thus undergone three surgical operations since his major surgery in 2008, which was covered by the Discovery channel. At the end of December 2010, two doctors from Japan, affiliated with the Japanese Society for Complementary and Alternative Medicine came and brought Dede alternative medicine in powder form, made from coix seeds. The medicine is still undergoing a lab test.

Dede’s Hand and Feet.
A character with epidermodysplasia verruciformis was profiled on season 5, episode 20 of Nip/Tuck in 2009.
A similar case was featured on Grey’s Anatomy season 7 in 2010.
Additionally, a similar character was featured in C.I.D in episode no. 797, “Raaz Chalte Pedh Ka” on February 3, 2012

Dede smoking.

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Ford and Microsoft


Anthony Frederick Augustus Sandys (born Antonio Frederic Augustus Sands) (1 May 1829 – 25 June 1904), but usually known as Frederick Sandys, was an English “Pre-Raphaelite” painter, illustrator and draughtsman, of the Victorian era

The Nightmare, 1857

Artistic studies
He was born in Norwich, England, and received his earliest lessons in art from his father, who was himself a painter. His early studies show that he had a natural gift for careful and beautiful drawing. In 1846 Sandys attended the Norwich School of Design. In the same and next year his talent was recognized by the Royal Society of Arts.

The Death of King Warwulf, 1862

Personal relationships
He married Georgiana Creed, but this marriage only lasted three years, although they never divorced. He had a long affair with the Romany woman Keomi Gray, who sat as a model both for him and Dante Gabriel Rossetti, and perhaps also for Simeon Solomon. He and Gray had at least two sons.

Danaë in the Brazen Chamber, wood engraving, signed by Swain, Museum of Fine Arts, Boston

In 1862 Sandys met actress Mary Emma Jones, known as Miss Clive, when she modeled for The Magdalen, now owned by the Norwich Castle Museum.

Portrait of Mary Sandys 1871

A relationship developed between the two, he became devoted to her, taking her as his common-law wife for the rest of his life. She gave birth to a large number of children, 10 of whom were raised under the name of Neville and survived after Sandys’ death. His work Proud Maisie made in 1867, was inspired by Mary, so much so that he made at least 11 versions by 1904.
He died in the Kensington area of London in 1904.

Mary Magdalene, Delaware Art Museum

Early work
He displayed great skills as a draughtsman, achieving recognition with his print parodying John Everett Millais’s Sir Isumbras at the Ford in 1857.

The Advent of Winter
The caricaturist turned the horse of Sir Isumbras into a donkey labelled J. R., Oxon. (John Ruskin). Upon it were seated Millais himself, in the character of the knight, with Rossetti and William Holman Hunt as the two children, one before and one behind. The caricature, produced using the new autographic lithographic, caused a lot of talk about who the artist might be and ultimately introduced Sandys to the London art community.

Study for Vivien black and red chalk Norwich-Castle

Rossetti and Sandys became close friends, and from May 1866 to July 1867, Sandys lived with Rossetti in Cheyne Walk, Chelsea. Sandys works were profoundly influenced by those of Rossetti. He focused mainly on mythological subjects and portraits.

Study for Autumn 1860 Norwich Castle Museum and Arts Gallery

Drawings and illustration

Study of Spring 1860 Norwich Museum
Some of the first introductions to Pre-Raphaelite teachings emerged in magazines, such as Once a Week, the Cornhill Magazine, Good Words and Sunday Magazine. Sandys began drawing in the 1860s for Once a Week, the Cornhill Magazine, Good Words and other periodicals, his work influenced by Albrecht Dürer, Ambrosius Holbein, and Alfred Rethel.

Morgan le Fay, 1864, Birmingham Museum & Art Gallery
Sandys made a total of 26 between 1859 and 1866, but each was a fine representation of this genre,
faithfully engraved by professional wood-engravers, including the Dalziel brothers and Joseph Swain, that they are worthy of the collector’s portfolio.

King Pelle’s Daughter

For the engravers to be successful in carving the intricate illustrations onto wood, they needed to start with a detailed, clear print from the artist. Sandys had an eye and talent for exacting detail, an intention to accurately reflect the subject, revealed in the quality of his works, equally impressive for its technical detail as for its imaginative point of view.

Grace Rose, 1866, Yale Center for British Art

Sandys’ The Death of King Warwulf is an example of his ability to create drawings that translated well for the engravings. Swirling shapes of flames, the curve the boat, its sail and the king’s clothes that surround him create a feeling of movement. The focal point is the king’s bowed head.

Amor Mundi
His last woodcut was on the subject of Danaë in the Brazen Chamber. It was engraved by Swain for Once A Week but suppressed by the publication’s editor, despite Sandys having the support of the magazine’s publishers, on the grounds that it was too sensuous.

Medea (Sandys painting), 1868

He drew only in the magazines. No books illustrated by him can be traced. So his exquisite draughtsmanship has to be sought for in the old bound-up periodical volumes which are now hunted by collectors, or in publications such as Dalziels’ Bible Gallery and the Cornhill Gallery and books of drawings, with verses attached to them, made to lie upon the drawing-room tables of those who had for the most part no idea of their

Conrad and Violet Flower

Chalk drawings of lettered men
He made a number of chalk drawings of famous men of letters, including Tennyson, Browning, Matthew Arnold, and James Russell Lowell.

Gentle Spring 1865
Studies for paintings

Study for Vivien depicts Sandy’s lover, Keomi Gray, as Vivien of Tennyson’s poem Idylls of the King. In the poem Vivien is the femme fatale in the story of King Arthur who used her looks to seduce Merlin to learn his secrets.

Proud Maisie

Sandys had previously used tales from King Arthur as inspiration for his work, such as King Pelles’ Daughter.

Helen of Troy 1867

He was drawn to stories of women who “seduce, entrap and destroy men, such as Helen of Troy, Morgan Le Fay and Medea.” Sandys portrays Vivien as a beautiful, self-assured woman.

La Belle Isolde 1862
The apple placed in front of her may refer to the story of Adam and Eve.

Olive Margaret Slaughter
Study for Autumn, made in 1860, is one of the many studies Sandys made before painting Autumn and provides evidence of Sandys’ skill as a draughtsman. He captures minute details, such as the soldier’s uniform and the plants and flowers. The study is much like the finished painting, except that the ginger jar is in the foreground.

Oriana 1861

Early in the 1860s he began to exhibit the paintings which set the seal upon his fame. The best known of these are Vivien (1863), Morgan le Fay (1864), Cassandra and Medea (1868).


Sandys never became a popular painter. He painted little, and the dominant influence upon his art was the influence exercised by lofty conceptions of tragic power.

Valkyrie 1868-1873

There was in it a sombre intensity and an almost stern beauty which lifted it far above the ideals of the crowd. The Scandinavian Sagas and Le Morte d’Arthur gave him subjects after his own heart.

Queen Eleanor

The Valkyrie and Morgan le Fay represent his work at its very best.

The Red Cap 1900

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