Diagnostic Considerations
The clinical differential diagnosis of verruciform xanthoma varies depending on the site. The differential diagnosis includes verruca vulgaris/condyloma acuminatum and oral papilloma.
Verruciform xanthoma can be misdiagnosed as verrucous carcinoma both clinically and microscopically if a superficial biopsy is performed. Verrucous carcinoma is of particular importance because, although it is a carcinoma, it shows little or no epidermal cytologic atypia. For this reason, superficial biopsy of verruciform xanthoma may be misinterpreted as verrucous carcinoma. Verrucous carcinoma can be distinguished from verruciform xanthoma by the presence of invasive epithelial proliferation, cellular atypia, and the lack of foamy histiocytic infiltrate. [12]
Differential Diagnoses
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Condyloma Latum
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Giant
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Papillomas
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Verruca Vulgaris
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Verrucous Hyperplasia
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Xanthelasma. Courtesy of Duke University Medical Center.
Tables
W Clark Lambert, MD, PhD Clinical Professor of Pathology, Clinical Professor of Medicine (Professor of Dermatology), Rutgers New Jersey Medical School; Professor of Pathology, Rutgers Graduate School of Biomedical Sciences
W Clark Lambert, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American Dermatological Association, American Federation for Clinical Research, American Society of Dermatopathology, College of American Pathologists, Dermatological Society of New Jersey, Institute of Electrical and Electronics Engineers, International Academy of Pathology, International Federation of Pigment Cell Societies, International Society of Dermatopathology, Medical Society of New Jersey, Sigma Xi, The Scientific Research Honor Society, Society for Investigative Dermatology, Xeroderma Pigmentosum Society
Disclosure: Nothing to disclose.
Hong Li, MD Pathologist and Dermatopathologist
Hong Li, MD is a member of the following medical societies: American Society for Clinical Pathology, College of American Pathologists
Disclosure: Nothing to disclose.
Fernanda Salgado Rutgers New Jersey Medical School
Fernanda Salgado is a member of the following medical societies: American Medical Association, Latino Medical Student Association
Disclosure: Nothing to disclose.
Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology
Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association
Disclosure: Nothing to disclose.
Jeffrey P Callen, MD Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine
Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American College of Rheumatology
Disclosure: Received income in an amount equal to or greater than $250 from: Biogen US (Adjudicator for study entry cutaneous lupus erythematosus); Priovant (Adjudicator for entry into a dermatomyositis study); IQVIA (Serono - adjudicator for a study of cutaneous LE) <br/>Received honoraria from UpToDate for author/editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for these trust accounts for: Stocks held in various trust accounts: Allergen; Amgen; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble;; Celgene; Gilead; CVS; Walgreens; Bristol-Myers Squibb.
William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine
William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology
Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.
Peter C Lambert, MS St George's University School of Medicine, Grenada
Disclosure: Nothing to disclose.
