Joshi Rajiv, Ovhal Ajay
Consultant Dermatologist and Dermatopathologist, PD Hinduja Hospital, Mahim, Mumbai, India.
Indian J Dermatol. 2012 Nov;57(6):479-82. doi: 10.4103/0019-5154.103069.
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.
我们描述了5例疣状黄瘤（VX）。患者均为男性，表现为大小为0.5 - 2厘米的单个疣状、乳头状病变，临床诊断为病毒疣（4例）和白斑（1例）。2例患者病变位于口腔，2例位于生殖器黏膜，1例位于阴囊皮肤。组织病理学检查具有诊断意义，表现为疣状和乳头状表皮增生，形似病毒疣，但在拉长的真皮乳头中有大量泡沫状组织细胞。深层角化不全柱和棘层上部的中性粒细胞，以及真皮浆细胞浸润是其他组织病理学表现。对2例口腔病变患者进行病变切除后治愈，无复发；生殖器病变患者未进行随访。VX是一种罕见但独特的临床病理实体，可累及口腔和生殖器黏膜，可能被误诊为良性、癌前和恶性病变。VX只有通过组织病理学检查才能确诊。
