Verruciform xanthoma‐like phenomenon in seborrheic keratosis

Abstract

Verruciform xanthoma is xanthomatous dermal infiltrate in a proliferating epidermal lesion and is an uncommon phenomenon. It has been reported in various neoplastic or inflammatory conditions. We report a 72-year-old man who had an asymptomatic 1-cm black nodule on his abdomen. Histopathology showed a typical acanthotic type of seborrheic keratosis characterized by basaloid keratinocyte proliferation and pseudohorn cysts. Many aggregated xanthomatized cells were seen in dermal papillae within the acanthotic epithelium. Papillomatosis, parakeratosis, and neutrophil infiltrates, the histologic features of typical verruciform xanthoma, were not seen. The foamy cells were positive for CD-68 and vimentin and negative for cytokeratin and S-100. No human papillomavirus DNA was found by nested polymerase chain reaction. The blood lipid profile was normal. The presence of verruciform xanthomatous change in seborrheic keratosis provides further evidence that verruciform xanthoma may be a reactive phenomenon occurring in common skin disorders.

Cellular basis of verruciform xanthoma: immunohistochemical and ultrastructural characterization

“…There are many reports on VX occurring within a variety of underlying mucocutaneous diseases which affect turnover and maturation of keratinocytes (for review, see Philipsen et al , 2003; Wu et al , 2006). These inherent or acquired conditions are known to drive the keratinocyte degeneration.…”

“…We confirmed, albeit in only 10 cases, the absence of virus particles. A marked heterogeneity of clinical settings offers an alternative explanation that VX may be a unique reaction pattern (for a review, see Philipsen et al , 2003; Wu et al , 2006). Presumably, an initiation event varies from site to site or patient to patient.…”

Verruciform xanthoma: A view on the concepts of its etiopathogenesis

“…But multiple lesions and its association with other diseases such as snuff dipper's keratosis, oral pemphigus vulgaris, carcinoma in situ , lichen sclerosus, solar keratoses, discoid lupus erythematosus, epithelial nevus, CHILD syndrome,[6] regressive dystrophic epidermolysis bullosa,[7] seborrheic keratosis[8] and psoriasis[9] have been reported.…”

Oral Verruciform Xanthoma Associated with Chronic Graft-Versus- Host Disease: A Report of Five Cases and a Review of the Literature

“…Although most of the cases of VX occur in otherwise healthy individuals, it has been reported in association with inflammatory conditions such as pemphigus vulgaris [9], lichen planus [10][11][12][13][14], discoid lupus erythematosus [15,16], warty dyskeratoma [17], psoriasis [18], epidermal nevus/CHILD nevus [5,19,20], dystrophic epidermolysis bullosa [21], and seborrheic keratosis [22]. It has also been associated with carcinoma in situ [23], and squamous cell carcinoma [24].…”