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An Ulcerating Verrucous Plaque on the Foot
Julia Ho, MD;
Dayna G. Diven, MD;
Pamela J. Butler, MD;
Stephen K. Tyring, MD, PhD
Duke University Medical Center Durham, NC (Dr Ho), University of Texas Medical Branch, Galveston (Drs Diven and Tyring), and Milwaukee Medical Clinic, Milwaukee, Wis (Dr Butler)
Arch Dermatol. 2000;136:547-552.
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REPORT OF A CASE
A 29-year-old African American man with long-standing type 1 diabetes mellitus, hypertension, retinopathy, nephropathy, and peripheral vascular disease that had resulted in leg amputation above the knee presented with a 4-year history of a verrucous lesion on his foot. It had been stable in size for 3 years but had intermittently ulcerated and healed. He had been seen by numerous physicians for what was thought to be a diabetic ulcer with a surrounding callus.
On physical examination, the patient was found to have a hyperkeratotic, partially ulcerated verrucous plaque on the plantar surface of his forefoot (Figure 1). No other verrucous lesions were noted. A podiatrist obtained a wedge biopsy specimen after attempts at healing were unsuccessful (Figure 2).
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Figure 1.
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Figure 2.
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What is your diagnosis?
Diagnosis: Verrucous carcinoma (epithelioma cuniculatum).
Microscopic examination of . . . [Full Text of this Article]
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