A giant verruciform xanthoma

Abstract

The failure to detect HPV DNA, even by very sensitive methods, provides strong evidence that our case of VX is not an HPV-induced lesion. A review of other possible etiologies, including alternative infectious agents and genetic associations, are discussed.

Verruciform xanthoma‐like phenomenon in seborrheic keratosis

“…Cutaneous involvement is unusual, although when it does occur, it is often seen in the genital area 6,13 . The lesions may be single 4 or multiple 31 and flat, verrucous or polypoid papules, nodules or plaques 4,29 , 32 . The diagnosis of verruciform xanthoma is based on the histologic pattern, which is characterized by papillomatous acanthosis, parakeratosis with a neutrophil infiltrate, and aggregations of xanthoma cells located between the acanthotic rete peges within the papillary dermis 1 .…”

“…The most likely culprit is HPV because of the morphologic similarity to warts, an association with skin malignancy, and the genital location 6 . However, most studies have failed to demonstrate the presence of HPV infection 3,29 , 32,42 , 43 . More recently, though, HPV DNA has been identified in some cases by nested polymerase chain reaction 33,34 , 46,47 .…”

“…6,13 The lesions may be single 4 or multiple 31 and flat, verrucous or polypoid papules, nodules or plaques. 4,29,32 The diagnosis of verruciform xanthoma is based on the histologic pattern, which is characterized by papillomatous acanthosis, parakeratosis with a neutrophil infiltrate, and aggregations of xanthoma cells located between the acanthotic rete peges within the papillary dermis. 1 Unlike in lipidemic xanthoma, foamy cells are usually not present in the reticular dermis.…”

“…6 However, most studies have failed to demonstrate the presence of HPV infection. 3,29,32,42,43 More recently, though, HPV DNA has been identified in some cases by nested polymerase chain reaction. 33,34,46,47 Although these findings suggest that HPV may play a role in the development of verruciform xanthoma, it was not observed in our case.…”

A rare case of giant verruciform xanthoma in the palate

“…It manifests mainly in the oral mucosa, but cases of verruciform xanthoma in the vulva, scrotum, penis, anal region, and extremities have been described [2][3] . The lesion is usually solitary and asymptomatic, and can have been present from a few weeks to years 4 .…”