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Verruciform Acral-Associated (Vacas) Xanthoma: Case Report and Review
Tejas P Joshi1, Antoanella Calame2,3, Philip R Cohen4
1Dermatology, Baylor College of Medicine, Houston, USA.
Cureus
|August 25, 2021
Summary
Verrucous xanthoma, a rare benign skin lesion, can occur on the extremities. This case highlights a non-mucosal verruciform xanthoma on the thumb, proposing the term "verruciform acral-associated xanthoma" for such cases.
Area of Science:
- Dermatology
- Histopathology
Background:
- Verrucous xanthoma is a rare, benign histiocytic lesion.
- It typically presents on oral or genital mucosa.
- Acral (hand/foot) distribution is uncommon.
Observation:
- A 69-year-old woman presented with a persistent verrucous xanthoma on her right thumb.
- Initial biopsy was misdiagnosed as callous; second biopsy confirmed verrucous xanthoma.
- Treatment with lactic acid and pumice stone reduced hyperkeratosis.
Findings:
- This report includes the sixth case of verrucous xanthoma on the hands and the 13th on acral sites.
- Acral verrucous xanthoma is rare, with only a few cases documented on hands and feet.
- The study proposes the term 'verruciform acral-associated xanthoma' (Vacas) for acral presentations.
Implications:
- The findings expand the known clinical spectrum of verrucous xanthoma.
- The proposed term 'Vacas' may improve classification and recognition of acral lesions.
- Understanding acral verrucous xanthoma aids in accurate diagnosis and management of rare skin conditions.
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