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Verruca vulgaris is a common skin lesion that is associated with human papilloma virus and is observed on the surface of skin. Verruca vulgaris is rarely seen in mucosal membranes. Atypical locations may be confused with verrucous carcinoma. The incidence of laryngeal verruca vulgaris has not yet been reported in the literature. Differential diagnoses in histopathological examinations include keratosis, squamous papilloma, verrucous hyperplasia, and verrucous carcinoma. Distinguishing disease from verrucous carcinoma is particularly important because the treatment approach can be altered. In this report, we present a rare case of laryngeal verruca vulgaris that was diagnosed on the basis of histopathological features.

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Objectives: To assess the feasibility of using Image1 S™ endoscopic enhancement system for discrimination of the vascular patterns in laryngeal lesions. Design: Forty patients presenting with benign, dysplastic and malign laryngeal lesions were examined with Image1 S system. The vascular patterns were classified by a group of the authors/ according to the ELS guideline, as perpendicular or longitudinal, in all lesions. Endoscopic images of the vascular patterns are evaluated through an online survey by a group of otolaryngologists with different levels of clinical expertise. The qualitative evaluation of the vascular patterns in two groups were compared to investigate the consistency. The relationship between the vascular patterns and the pathological results was statistically analyzed. Results: Eleven patient presented with benign, 13 patients with dysplastic and 16 patients with malignant pathology. The vascular patterns were longitudinal in 9 lesions, perpendicular in 28 lesions and undetectable in 3 lesions. The relevance between the vascularization pattern and the pathological diagnosis was found to be significant (χ2= 20.30, p < 0,001). The qualitative evaluation of the vascular patterns by the two groups of observers was significantly close to each other (=0.63). The survey also showed that spectral modes producing high contrast images were preferred by 81,9% of the participants over white light images. Conclusion: This study demonstrated the usefulness and feasibility of Image1 S endoscopic enhancement system to predict the diagnosis from vascular changes in laryngeal lesions.