Hanny Enterprises runs a profitable freak show. For 10,000 rupiah (about a dollar), the public sees feats of strength, strange exhibitions of unusual abilities (one performer can eat glass), and gets a look at people whose appearance is outside the ordinary.
Hanny made "Tree Man" a star. "I didn't make any promises," says Hanny. "Rather than [having] him stay home, not doing anything and being a burden to his family, it means that if he joins, lots of people will come and show pity on him and help him."
People flocked to Hanny's show, and doctors were as interested in Dede as the rest of the public. They decided to find out what on earth was going on in his body. It turned out to be a "perfect storm" of dermatology: perhaps the worst case of warts (usually considered just a minor annoyance) known to medical science today, coupled with an unusual inability to fight them off. A common virus (one you've got if you've ever had a wart!) was taking over Dede's skin.
"This is the most remarkable case, the most severe case, I have seen in my career," says Dr. Anthony Gaspari from the University of Maryland, who specializes in immune function of the skin. "I was actually asked by the Discovery Channel to join them and to study this patient and confirm what kind of health problem he had."
A small medical digression: what are warts, anyway?
"Warts are viral growths on the skin, creating extensions of the skin, which have a full blood supply -- they become part of the skin," says New York City dermatologist Dr. Debra Jaliman, an assistant professor of Dermatology at Mt. Sinai School of Medicine. "They can occur anywhere. Warts are caused by the human papilloma virus (HPV) and are very common. Anybody can get warts."
Jaliman says warts are very contagious and kids get them from playing with other kids. "They touch other kids' hands that have warts," says Jaliman. "Sometimes the children take baths with their siblings, so all the kids in the family get warts. You can get it from the surface of a public pool. They are very common, and if you don't treat them, they can stay within the skin's surface. If you have it on one finger, it can go to the finger adjacent to it. And sometimes people think that if they have one wart it's going to go away, and they don't treat it. Then they have ten warts and twenty warts and sometimes we see one hundred warts. So it can become a big problem."
Jaliman cautions that warts need to be treated, and over-the-counter remedies can work. But, if the problem persists, a dermatologist should be consulted. She treats patients with liquid nitrogen, which freezes the warts, and sometimes prescribes stronger acids that you can get at a pharmacy to burn away the growths. Other medicines? Immune stimulators (creams that stimulate the body's immune system to destroy the wart virus) and even, in the worst cases, laser treatment.
The treatments don't leave scars; they're straightforward and relatively easy to do, but, says Jaliman, "You have to be persistent and very aggressive. Some people don't do well with the treatments because their immune system isn't that good at fighting the virus. It's always better to treat a virus early. In other words, if you get one wart, it's a lot easier to treat than if you have twenty warts. So I always encourage parents -- if you start to see warts on your kids, come early and get the virus treated."