The cutaneous pathology of extrafacial lesions in Cowden's disease

Twenty extrafacial lesions from 6 patients with Cowden's disease were studied. Most were hyperkeratotic papillomas that resembled verruca vulgaris, acrokeratosis verruciformis, or hyperkeratotic acanthomas. Small hyperkeratotic papillomas frequently showed abnormalities of the follicular infundibulum. Occasionally, follicular abnormalities were seen without concomitant epidermal hyperplasia. It is concluded that some of the extrafacial lesions may originate from the follicular infundibulum. No evidence of a virus infection was found using an antiserum to papilloma virus.