Wu Yu-Hung, Hsiao Pa-Fan, Lin Yang-Chih
Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan.
J Cutan Pathol. 2006 May;33(5):373-7. doi: 10.1111/j.0303-6987.2006.00431.x.
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.
疣状黄色瘤是一种在增生性表皮病变中的黄色瘤性真皮浸润，是一种罕见现象。它已在各种肿瘤性或炎症性疾病中被报道。我们报告一名72岁男性，其腹部有一个无症状的1厘米黑色结节。组织病理学显示为典型的棘皮瘤型脂溢性角化病，其特征为基底样角质形成细胞增生和假角质囊肿。在棘皮瘤样上皮内的真皮乳头中可见许多聚集的黄色瘤化细胞。未见到典型疣状黄色瘤的组织学特征，即乳头瘤病、不全角化和中性粒细胞浸润。泡沫细胞CD-68和波形蛋白呈阳性，细胞角蛋白和S-100呈阴性。通过巢式聚合酶链反应未发现人乳头瘤病毒DNA。血脂谱正常。脂溢性角化病中出现疣状黄色瘤样改变进一步证明疣状黄色瘤可能是常见皮肤疾病中发生的一种反应性现象。
