Multiple cancerous lesions develop after middle age. EV lesions are resistant to interferon and immunotherapy, and require surgical treatment with skin grafts.

2The 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-, interferon-, or bleomycin. Because she had had multiple surgical treatments, areas with normal skin suitable for grafting were limited. Two cm 2 of clinically normal skin distant from the Bowenoid cancers and warts was harvested after obtaining informed consent. Keratinocytes were cultured from the specimen 3 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 3year follow-up. To eliminate HPV infection in cultured epidermal sheets, HPV DNA was analysed by a PCR protocol specifically detecting tumorigenic HPV. 4 DNA samples were prepared from a verruca plana lesion, two different BC lesions excised from the same patient and the cultured epidermal sheets. EV-related HPV DNA specific bands were amplified in both of the samples from the BC lesions and verruca plana lesion the same as HPV-47 DNA control; no EV-related HPV DNA was detected in the cultured epidermal sheets. There was no relapse of the verruca for 3 years, which also supports the results of PCR analysis. Since there is no established curative treatment, a self-skin banking system may