Workup
Laboratory Studies
Because warty dyskeratoma (WD) has repeatedly been shown to be a lesion not associated with systemic disease, no laboratory studies are necessary.
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Imaging Studies
No imaging studies are necessary.
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Procedures
A biopsy specimen interpreted by a dermatopathologist is the criterion standard for diagnosis.
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Histologic Findings
The pathologic process is that of a well-circumscribed endophytic or endo-exophytic epithelial proliferation of benign squamous cells demonstrating elongated dermal papillae (villi) with suprabasilar acantholysis and dyskeratosis. Dyskeratotic cells are referred to as corps ronds and grains. A central keratin-filled invagination may be identified. The lesion can sometimes be seen originating from a hair follicle or sebaceous gland.
Warty dyskeratoma. An endo-exophytic squamous proliferation of cytologically benign, acantholytic, and dyskeratotic keratinocytes.
Villi lined by acantholytic keratinocytes, some of which are dyskeratotic (corps ronds and corps grains).
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Media Gallery
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Absence of sarco/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2) staining by immunohistochemistry within a warty dyskeratoma (right side of image), in contrast to the unaffected epidermis (left side of image). Photomicrograph courtesy of James E. Fitzpatrick, MD.
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Warty dyskeratoma. An endo-exophytic squamous proliferation of cytologically benign, acantholytic, and dyskeratotic keratinocytes.
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Villi lined by acantholytic keratinocytes, some of which are dyskeratotic (corps ronds and corps grains).
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