A Bangladeshi man who suffers from an extremely rare genetic disease known as "tree man" syndrome is back in hospital and faces more surgery after the condition returned after multiple operations in 2016.
Abul Bajandar, a 28-year-old father from a small town in southern Bangladesh, made headlines three years ago when he underwent a series of complex operations to remove lesions which resemble tree branches from his hands and feet.
Bajandar has been living with the disease, epidermodysplasia verruciformis, for more than two decades, resulting in extreme wart-like growths across his body.
The condition is caused by a defect in the immune system which increases one's susceptibility to HPV, or human papilloma virus, often leading to chronic HPV infection, skin lesions and an increased risk of developing melanoma skin cancer. It is so rare there have only been a handful of reported cases around the world.
Doctors told CNN that Bajandar has had more then 25 surgeries since 2016 but skipped out of further treatment in May.
"It's a complicated case and we were making progress but he left to go home. I requested him many times to come back but he didn't," said Dr. Samanta Lal Sen, co-ordinator at the Burn and Plastic Surgery Unit of Dhaka Medical College and Hospital.
"He came back to the hospital on Sunday with his mother. He should have come here six months back. He came too late."
Bajandar's condition has now worsened, with lesions on his hands around one-inch long. The warts have also spread to his feet and other parts of his body, doctors said.
Sen's team are now working on a plan for Bajandar's future treatment and said he will need five to six more operations.
Sen told CNN in 2016 that Bajandar first noticed the lesions when he was 10. Over time, the growths completely encompassed his hands, stealing his livelihood as a rickshaw driver and making him the subject of international news.
Before the surgeries, Bajandra could not eat, drink, brush his teeth or take a shower by himself.
"I want to live like a normal person. I just want to be able to hold my daughter properly and hug her," he told CNN at the time.
In 2017, the surgeries had left him in "very good shape," enabling him to eat and write using his own hands, Sen told CNN in a previous report, but now more treatment is needed.
The government bore the cost of his treatment in 2016 and Sen said this will extend to any new surgeries Bajandra now needs.