Verruciform Xanthoma on the Scrotum

Abstract

A case of 80-year-old man with a verruciform xanthoma on the right side of the scrotum was reported. The tumor was examined histologically by light and electron microscope. We surveyed the literature and found 25 Japanese cases and 11 foreign cases in the skin. We also reviewed the pathogenesis and the location of this disease.

Cellular basis of verruciform xanthoma: immunohistochemical and ultrastructural characterization

“…Squamous epithelia are active sites of lipid biosynthesis (Uchiyama et al , 2000) and epidermal lipids are increased in chronic inflammatory dermatoses including VX (Shindo et al , 1985; Uchiyama et al , 2000). Both membrane‐bounded vacuoles in the keratinocytes (Zegarelli et al , 1975; Ronan et al , 1984; Nakamura et al , 1989; Balus et al , 1991) and foamy macrophages in the epithelium (Zegarelli et al , 1975; Cobb et al , 1976; Ronan et al , 1984), as we demonstrated, may offer ultrastructural evidence that lipids are epithelial in origin. Of interest is the recent report that genetic alterations of 3 β ‐hydroxysteroid dehydrogenase are associated with a small subset of cutaneous VX (Mehra et al , 2005).…”

“…The etiopathogenesis of VX remains elusive to date. Previous pathologic studies investigated the fine structure (Zegarelli et al , 1975; Cobb et al , 1976; Palestine and Winkelmann, 1982; Ronan et al , 1984; Nakamura et al , 1989; Travis et al , 1989; Balus et al , 1991) and immunoprofile (Mostafa et al , 1993; Iamaroon and Vickers, 1996; Mohsin et al , 1998) of foam cells. As a result, mutual interactions among keratinocytes, macrophages, neutrophils, and lymphocytes are still uncertain.…”

Vegas (Verruciform Genital-Associated) Xanthoma: A Comprehensive Literature Review

“…This is an interesting hypothesis since there is a significant number of scrotal verruciform xanthomas reported in the Japanese literature [34, 35, 42]. These findings support Zegarreli et al’s proposal that verruciform xanthoma formation may be linked to epithelial degeneration due to irritation [81].…”

Verruciform Xanthoma in Close Association with Isolated Epidermolytic Acanthoma: A Case Report and Review of the Japanese Dermatological Literature

“…Histologic findings include papillomatous growth of the epithelium and xanthoma cell infiltration of the papillary dermis. Shindo et al(3) first reported a Japanese case in 1981, and, at present, 130 patients have been described in the Japanese dermatological literature (4–34). The patient age has ranged from 11 to 98 years (mean, 65.8).…”