IntroductionVerruciform xanthoma is a wart-like benign lesion. The classic histologic appearance consists of foamy histiocytes within elongated dermal papillae and epithelial acanthosis. The lesion most commonly occurs in the oral cavity, but has been reported in extra-oral sites such as the penis, scrotum, and vulva. The clinical and histologic characteristics of verruciform genital-associated (Vegas) xanthomas of the penis, scrotum, and vulva are reviewed.MethodsPubMed was used to search the following term: verruciform xanthoma. The relevant papers were obtained and reviewed.ResultsThere have been 193 cases of genital-associated verruciform xanthomas. There were 164 in men and 29 in women. Similar to verruciform xanthomas of the oral mucosa, they presented as asymptomatic lesions, demonstrated foam cells in the dermal papillae, and were typically managed successfully with surgical excision.ConclusionVerruciform xanthoma is a benign lesion characterized by a wart-like growth that is most commonly seen in the oral mucosa. Verruciform xanthomas of the genital region have been coined Vegas xanthomas. Vegas xanthomas have been reported in association with a variety of diseases, as well as in healthy individuals. Biopsy is required for diagnosis, and complete surgical excision is typically curative.

Pigmented lesion classification poses a challenging task for dermatologists and pathologists alike given the variable clinical and histologic presentations. Melanoma has increased potential for morbidity and mortality compared to non-melanoma skin cancers, and it is now the third most commonly diagnosed cancer in the United States (Marghoob et al., 2009;Welch et al., 2021;Whiteman et al., 2016). While dermatologists require the fewest number of biopsies per diagnosis of cutaneous malignancy, both providers and patients must nevertheless accept that any skin biopsy exchanges diagnostic information for scar tissue (Nelson et al., 2019). Finding a diagnostic balance can be difficult, especially on the cosmetically sensitive regions of the face. Dermatologists have a 65-80% accuracy rate in melanoma diagnosis without the use of epiluminescence microscopy (dermoscopy). Artificial intelligence (AI) has potential to be a useful adjunct tool to assist dermatologists with this challenging diagnosis (Argenziano & Soyer, 2001). Thus, it is imperative that dermatologists understand the basics of AI.

Palisaded granulomatous dermatitis is an uncommon pathologic condition potentially associated with several disorders. These include drugs, inflammatory bowel disease, multiple myelomas, rheumatoid arthritis, and systemic lupus erythematosus. An illustrative case of a man with palisaded granulomatous dermatitis who subsequently developed ulcerative colitis is described, and the characteristics of other individuals with ulcerative colitis-associated palisaded granulomatous dermatitis are reviewed. PubMed was used to search the following terms: palisaded, interstitial, granulomatous, dermatitis, ulcerative colitis, and neutrophilic. Papers were obtained and references were reviewed. Ulcerative colitis-associated palisaded granulomatous dermatitis is uncommon. Palisaded granulomatous dermatitis-associated ulcerative colitis has been reported in four individuals. The palisaded granulomatous dermatitis appeared from six years prior to diagnosis to 19 years following diagnosis of the patient’s gastrointestinal disease. In addition to individual and grouped papular lesions on the elbows, the morphology of palisaded granulomatous dermatitis can also present as indurated linear plaques overlying the metacarpophalangeal (MCP) joints and proximal fingers.

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