Verruciform xanthoma in an epithelial nevus

Area of Science:

• Dermatology
• Pathology
• Genetics

Background:

• Verruciform xanthoma (VX) is a rare epithelial lesion typically found on oral or mucosal surfaces.
• Histologically, VX is characterized by a verruciform epithelium with parakeratosis and foam cells in dermal papillae.

Observation:

• This report details the second extramucosal verruciform xanthoma, occurring in a young patient with a phocomelic extremity and an epithelial nevus.
• The lesion was notably large and associated with abnormal keratinization and mast cell proliferation.

Findings:

• Microscopic examination revealed foam cells, abnormal keratinization, and mast cell proliferation.
• The verruciform xanthoma appeared to be a reaction to an underlying epithelial nevus and developmental anomaly.

Implications:

• This case expands the clinical spectrum of verruciform xanthoma, particularly in extramucosal locations.
• It suggests a potential link between verruciform xanthoma, epithelial nevi, and developmental anomalies.