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A Scaly Plaque on the Scalp—Diagnosis
Arch Dermatol. 2007;143(8):1067-1072.
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Diagnosis: Verruciform xanthoma (VX).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Pathologic examination of the biopsy specimen demonstrated a papillated epidermis with verrucoid hyperplasia, hyperkeratosis, parakeratosis, and hypergranulosis. The papillary dermis was filled with xanthomatous cells, which were periodic acid–Schiff negative. There was no epithelial atypia, and viral inclusions were absent. A dermal fibrosis was present along with a mixed lymphocytic and plasma cell perivascular infiltrate. The rest of the plaque was completely excised. The adjacent tissue revealed thickened organized collagen, with loss of follicular and adenexal structures. However, there was no apparent thickening of the basement membrane. Follow-up examination at 6 weeks showed no evidence of VX recurrence or active lesions of DLE.
DISCUSSION
Verruciform xanthoma is a rare, benign neoplasm of unknown origin predominantly involving the oral cavity. Since its discovery in 1971, several extraoral manifestations have been described, primarily in the anogenital area but also on the nose, axillae, neck, and scalp. Many of these skin lesions have been . . . [Full Text of this Article]
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Arch Dermatol. 2007;143(8):1067-1072.
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