The initial 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 cutaneous tumors.Generally, cutaneous lesions are spread over the body, but some cases have only a few lesions which are limited to one extremity. Genetics
Most patients with classic EV carry bialletic loss-of-function mutations of transmembrane channel-like protein 6 (TMC6; also called EV protein 1, EVER1), TMC8 (also called EVER2), or calcium- and integrin-binding protein 1 (CIB1). The EVER1 or EVER2 genes are located adjacent to one another on chromosome 17. These genes play a role in regulating the distribution of zinc in the cell nuclei. Zinc is a necessary cofactor for many viral proteins, and the activity of EVER1/EVER2 complex appears to restrict the access of viral proteins to cellular zinc stores, limiting their growth.Other genes have also rarely been associated with this condition. These include the ras homolog gene family member H.

Treatment
No curative treatment against EV has been found yet. 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.
Symptoms and classification
The professional handbook of the American Psychiatric Association (APA), the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, lists the following diagnostic criteria for frotteuristic disorder. Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors. The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.If the individual has not acted on their interest and experiences no distress or impairment, they are considered to have a frotteuristic sexual interest, but not frotteuristic disorder. Some sexologists distinguish between frotteurism (as pelvic rubbing) and toucherism (as groping with hands), but the DSM does not. Sexologist Kurt Freund described frotteurism and toucherism as courtship disorders that occur at the tactile stage of human courtship. Prevalence and legality
The prevalence of frotteurism is unknown. The DSM estimates that 10%–14% of men seen in clinical settings for paraphilias or hypersexuality have frotteuristic disorder, indicating that the population prevalence is lower. However, frotteuristic acts, as opposed to frotteuristic disorder, may occur in up to 30% of men in the general population. The majority of frotteurs are male and the majority of victims are female, although female on male, female on female, and male on male frotteurs exist.