warts are benign skin tumors that commonly involve the skin and other epithelial tissues , caused by human papilloma virus infection . hpv type 3 and , less often , types 10 , 27 , and 41 most often causes flat warts [ verruca plana ] . they generally occur in multiples and are grouped on the face , neck , dorsa of the hands , wrists , or the knees . in rare instances , there is extensive involvement with lesions on the extremities and trunk as well . this is the first reported case of verruca plana , with its extensive and exclusive involvement of the trunk , and absolute sparing of the sun - exposed areas in a healthy individual . a 27-year - old man presented with non - itchy hyperpigmented papular skin lesions involving the trunk since 3 years . there was no family history of similar lesions . on examination , numerous hyperpigmented , rough , slightly elevated papules , with size in the range of 2 - 4 mm diameter most of the papules coalescing to form plaque - like lesions involved the back , chest and abdomen , with absolute sparing of the other areas of the body [ figure 1a and b ] . a ) numerous hyperpigmented , rough , slightly elevated papules coalescing to form plaque - like lesions over the chest and abdomen , b ) similar lesions over the back . histopathologically , epidermis showed hyperkeratosis , focal mild irregular acanthosis with koilocytic changes in most of the keratinocytes . cellular or nuclear enlargement , dysplastic changes , or keratohyaline pigmentation were absent [ figure 2 ] . histopathology of warty lesions showing epidermal hyperkeratosis , focal mild irregular acanthosis with koilocytic changes in most of the keratinocytes . cellular or nuclear enlargement , dysplastic changes or keratohyaline pigment are absent [ h and e , stain  20 ] investigations were carried out to determine the immune status of the patient . the result of enzyme - linked immunosorbent assay ( elisa ) for hiv was negative . warts are benign proliferation of the skin resulting from infection with human papilloma virus ( hpv ) . on skin , hpv infection may manifest as common warts , flat warts , and filiform warts . depending on the site , palmar and plantar warts , anogenital warts , oral warts and conjunctival warts may also occur . hpv type 3 and , less often , types 10 , 27 , and 41 often cause flat warts . plane warts are smooth , skin colored or pigmented , 1 - 5 mm papules usually seen on the face , dorsa of hands and shins . interestingly , in our case , there has been involvement of only the trunk with absolute sparing of other areas . histopathologically , verrucae planae shows hyperkeratosis and acanthosis but , unlike verruca vulgaris , these have no papillomatosis , but only slight elongation of the rete ridges , and no areas of parakeratosis also . in the upper stratum malpighii , including the granular layer , there is diffuse vacuolization of the cells . some of the vacuolated cells lie at the centers of the cells , and some of them appear deeply basophilic . all these features were consistent with findings of our case . the extensive involvement of verrucae planae in our case led us to rule out conditions like darier 's disease and epidermodysplasia verruciformis , as the typical dirty - appearing , greasy papules sparing the face and neck were absent . further , family history in the former was absent , and there was lack of associated tinea versicolor - like lesions in the latter . we report this case because we found that in the absence of hiv infection or any other immunocompromised condition , such extensive presentation of verruca plana was possible .
a 27-year - old healthy man presented with non - itchy hyperpigmented skin lesions involving the trunk of duration 3 years . 
 examination revealed numerous coalescing , rough , slightly elevated brownish papules involving large areas of back , chest , and abdomen . 
 there were no other cutaneous or systemic findings . 
 cutaneous biopsy was suggestive of verruca plana , which confirmed our clinical diagnosis . here , 
 we report this case of verruca plana due to its rare extensive involvement and unusual site in a non - immunocompromised individual .