Progression of HPV-related Epidermodysplasia Verruciformis (EV) Genital warts usually appears in the first decade of life. In about one-third patients with young adulthood onset, the warts undergo malignant transformation. The lesions transform into invasive squamous cell carcinoma. This invasive fashion originates from actinic keratoses especially in people who are exposed to radiation and sun. This condition mostly affects sun-exposed areas. Therefore, the condition regresses in individuals who avoid X-rays and sun exposure. EV progresses towards malignancy in the third or fourth decades of life.