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'Tree man' leaves hospital with warts removed

Tree man Dede shows off his new ability to hold a pen at a news conference to mark his release from hospital

The Indonesian fisherman who became known around the world as “tree man” has returned home after successful surgery to remove the bark-like growths covering his body.

Dede Koswara has had nearly a stone of warts cut from his face, arms and legs and is now able to live independently for the first time since his teens.

The 37-year-old has been allowed to leave the hospital in West Java where he has nine operations to remove 95 per cent of the growths, known as cutaneous horns.

At a press conference Dede showed off his new ability to grip a pen, a feat that had been made impossible by the foot-long "roots" that previously covered his hands.

His face, which had been dominated by large warts, appeared clear apart from a few blemishes
He will celebrate Ramadan, the Islamic fasting festival, with his family, before returning to the hospital for further surgery to trim his remaining warts.

"He cannot be 100 per cent cured, but his life quality has improved. If once he depended on others to do his activities, now he can eat by himself, use his hand to write, use the cell phone," said Rachmad Dinata, one of the doctors who has treated Dede at the Hasan Sadikin provincial hospital.

"We sent him home so he can gather with his family again, especially ahead of the fasting month. It will mentally help the healing process."

Dede’s plight came to the attention of the world last year after Telegraph.co.uk reported on an American doctor who claimed to have identified his condition, and proposed a treatment that could transform his life.

The tree-like welts covering his body were caused by the Human Papilloma Virus (HPV) which defects in Dede’s immune system left him unable to fight, according to Dr Anthony Gaspari of the University of Maryland.

After the publicity generated by the article and a television documentary, the Indonesian government intervened to fast-track his treatment.

Dede went under the knife for his first operation in January. When Telegraph.co.uk spoke to him in hospital in March he described the pleasure of being able to walk without pain for the first time in 20 years.

He also expressed his hopes for the future. "What I really want first is to get better and find a job. But then, one day, who knows? I might meet a girl and get married," he said.
Doctors have warned him that the warts may grow back, but his condition is no longer life threatening.

Indonesian ‘tree man’ has bark-like growths

Doctor hopes to treat rare skin condition that causes warty roots

An Indonesian man suffering from a rare skin condition that causes his body to be covered with tree-like growths may soon get help from an American doctor, according to a report in the British newspaper the Telegraph.

Dede, 35, who has gnarled growths sprouting from his hands and feet, has baffled medical experts since the warty "roots" began appearing after he injured himself as a teenager.
But dermatology expert Dr. Anthony Gaspari, a specialist in immunology and skin allergies at the University of Maryland School of Medicine, Baltimore, told the newspaper that he can treat the condition.

After testing samples of the lesions and Dede's blood, Gaspari, who examined the villager as part of a documentary, concluded that the infection is caused by the human papillomavirus (HPV), a fairly common condition that usually causes small warts to develop in the genital area.

However, a genetic flaw has prevented Dede's immune system from controlling the warts, allowing the virus to produce a substance that caused cutaneous horns on his feet and hands, the newspaper reports.

Because of a genetic condition the Indonesian villager's immune system can't fight off a virus which causes massive bark-like growths.

Gaspari told the newspaper that a course of synthetic vitamin A should clear up most of the massive warts and root-like tendrils that have left Dede unable to work.

Although the medical treatment won't give him a normal body, the growths should shrink enough that Dede could use his hands, the doctor told the Telegraph.

Despite his genetic condition, the villager has been otherwise healthy and has two children, ages 16 and 18. However, his wife has left him and his children have been brought up by extended family nearby, according to the paper.

The Indonesian Health Minister Siti Fadillah Supari said that an Indonesian medical team would cooperate with Gaspari, but the minister also reportedly criticized the Discovery Channel, who produced the TV documentary, for exploiting the villager.

'Tree man' Dede Koswara almost died from his disease

The 37-year-old entered an Indonesian hospital because of the huge tree-like growths that had encased his limbs for 20 years.

But an X-ray quickly revealed that the immune deficiency stopping him fighting the warts had also allowed a potentially deadly TB infection to take hold.

Dr Rachmat Dinata, leading the team treating Dede at the Hasan Sadikin Hospital in Bandung, West Java, said: "Five years from now, he would have been dead.
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"He had lots of very active bacteria in his lungs. If he hadn't come here, and instead had lived his life as he had, with bad food and not enough of it, then the disease would have spread quickly."

However, intensive treatment has allowed Dede to beat the infection since arriving in hospital in January.

Dr Dinata said: "After three months treatment we have done an X-ray to check. His lungs are clear."

Dede's ordeal began when he was 15 and cut his knee in an accident. A small wart developed on his lower leg and spread uncontrollably.

"The warts began appearing everywhere," he told the Telegraph.

Eventually he had to give up work as a builder. His wife of ten years left him as it became impossible for him to support her and their two children.

Late last year, however, Dede's plight was highlighted on Telegraph.co.uk and in a Discovery Channel documentary.

The documentary team took American dermatology expert Dr Anthony Gaspari to Indonesia to see if he could find a cure.

Dr Gaspari, of the University of Maryland, is now liaising with the team treating Dede in Bandung.

He concluded Dede's affliction was caused by the Human Papilloma Virus (HPV), a fairly common infection usually causing only small warts.

Dede, however, has an extremely rare immune system deficiency, leaving his body unable to contain the warts. The virus was able to "hijack the cellular machinery of his skin cells", ordering them to produce massive amounts of the substance causing tree-like growths known as "cutaneous horns".

Dr Dinata revealed the immune deficiency is so severe they have to be extremely wary of transmitting infections to Dede.

He said: "He is like an HIV patient, but he is negative. Because his immunity system is so weak, it's easy for other infections to enter his body. We have to be very careful around him if we have flu."

Four major operations have removed most of Dede's growths, including 4lbs of warty tissue from his feet alone. His hands are still massive clumps, but he can now use them for the first time in more than a decade.

He enjoys doing sudokos, but it can take him several days to complete one – not only are the puzzles challenging in themselves, the remaining growths on his hands still make it difficult for Dede to use a pen.

Dede has three more months of treatment to go before doctors think he will be fully cured, and is tentatively making plans for the future.

He told the Telegraph: "If all the growths are gone, I want to work again. If I had some seed money I would like to open a small business in my village, selling whatever I could."
He also laughed as he confirmed that he would also like to remarry.
"Yes I would like to get married again."