Verruciform xanthoma: Report of five cases

Abstract

We describe five cases of verruciform xanthoma (VX). The patients, all males, presented with single warty verrucous lesions of 0.5–2 cm size that had been diagnosed clinically as viral warts (four cases) and leukoplakia (one case). Two patients had the lesion in the oral cavity, two on the genital mucosa, and one on the scrotal skin. Histopathology was diagnostic, with verrucous and papillomatous epidermal hyperplasia with the silhouette of a viral wart but with numerous foamy histiocytes packed in the elongated dermal papillae. Columns of deep parakeratosis and neutrophils in the upper spinous layers, with a dermal plasma cell infiltrate were the other histopathologic findings. Excision of the lesions was curative, without recurrences, in the two patients who had lesions in the oral cavity; follow-up was not available in the cases with genital lesions. VX is an uncommon but distinctive clinicopathologic entity affecting the oral and genital mucosa that may be mistaken for benign, premalignant, and malignant conditions. VX can be diagnosed with certainty only on histopathologic examination.

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

“…The patient noticed a nodule on the nonpsoriatic part of his scrotum while receiving systemic and topical PUVA therapy. The nodule appeared when the cumulative UVA dosage reached 27.6 J/cm 2 c This patient had four 2–3-mm diameter red papules adjacent to his 7 mm verrucous nodule d The patient also had a pulsating subcutaneous induration covered by lightly purplish skin under his scrotal nodule e Joshi and Ovhal [ 2 ] documented a case of a single scrotal lesion that was diagnosed as a verruciform xanthoma in their report. There was no other information available on the patient f Mehra et al stated that one patient in their study had 2 scrotal lesions appearing at different times in the same year [ 46 ].…”

“…e Joshi and Ovhal [ 2 ] documented a case of a single scrotal lesion that was diagnosed as a verruciform xanthoma in their report. There was no other information available on the patient…”

Verruciform xanthoma of the tongue

“…Diagnostic finding of verruciform xanthoma is the presence of foam cells in submucosal spaces. [ 1 4 ] Depending on light microscopic views, Nowparast et al . described verruciform xanthoma into three different types.…”

“…[ 2 ] Shafer in 1971 presented 15 cases of xanthoma and was the first to coin the term verruciform xanthoma. [ 3 4 ] Verruciform xanthoma can occur as a result of irritation to the oral mucosa or unknown immune reaction. However, etiology and pathogenesis of this lesion are not yet clearly described in the available literature.…”

Dermatopathology quiz: Cerebriform papules of the scrotum

“…[ 2 ] Due to the similar clinical appearance and distribution of verruciform xanthoma and condylomata, human papilloma virus (HPV) has been suggested as an etiologic factor, but in situ hybridization has generally failed to find evidence of a genuine association with HPV. [ 1 3 ]…”