Verruciform xanthoma of the skin

Verruciform xanthoma is an unusual lesion characterized by verrucous epithelial proliferation accompanied by a prominent replacement of the dermal papillae with large numbers of foamy histiocytes. Cases have been previously reported only as occurring in the oral cavity or, more rarely, on the vulva. A 16-year-old girl developed a verruciform xanthoma of the skin. The lesion appeared to arise within a large epithelia nevus involving the left inner thigh and inguinal area. This association supports the concept that verruciform xanthoma is a rare inflammatory reaction pattern that may be seen in a variety of squamous epithelial lesions characterized by verrucous hyperplasia.