We herein present a case of annular basal cell carcinoma (BCC) with spontaneous regression on the right temporal region of a 56-year-old Japanese male. Histopathological examination revealed that the central section had no tumor cells. The sweat glands, follicles, and other cutaneous appendages were also absent. This pattern of spontaneous regression is quite uncommon, and understanding the histopathology may be important for future approaches to BCC.

Anogenital warts are caused by human papillomavirus types 6 and 11. They are rare in children, and treatment is difficult since conventional treatments are generally painful and require the patient to be anesthetized. Topical diphenylcyclopropenone (DPCP) is a contact immunotherapy used for treatments of recalcitrant warts and alopecia areata. We herein report 3 cases of anogenital warts in children successfully treated with topical DPCP. Our results suggest that topical DPCP may be a valuable option for the treatment of anogenital warts in children who have difficulty with painful destructive therapy.

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The pigmented warts caused by human papillomavirus (HPV) infection are rarely observed in HPV 4, 60 and 65. 1,2 Histopathologically, these pigmented warts contain characteristic intracytoplasmic inclusion bodies in the upper epidermis and many melanin blockade melanocytes as well as abundant melanin granules in the basal cells and suprabasal cells. 1,2 We describe a case of recalcitrant pigmented warts observed in a child. In addition, combined therapies of low-dose oral retinoid and topical 10% salicylic acid were fairly effective.A 12-year-old Japanese boy presented with asymptomatic pigmented lesions on his neck and upper chest. He had been practicing baseball for 5 days a week and was exposed to ultraviolet light. He first noticed the verrucous lesions approximately 5 years prior, and he had no history of immunosuppressive disorder. Initially, cryotherapy was performed, but the lesions were resistant. The lesions had gradually increased in number and size over the course of previous treatments. Clinical examination revealed a large number of small, elastic, soft, grayish nodules on his neck and upper chest (Fig. 1a). The skin lesion was biopsied, and histopathology showed that the epidermis was thickened, and a few dyskeratotic cells were seen in the epidermis. A characteristically large number of vacuolated cells in the epidermis, increased intrapapillary capillaries and marked basal hyperpigmentation were observed. However, no characteristic intracytoplasmic inclusion bodies (a) (b) (c) (d) Figure 1. Clinical and histological features of the recalcitrant pigmented warts. (a) A large number of small, elastic, soft, grayish nodules on the patient's neck and upper chest. (b) A characteristically large number of vacuolated cells in the epidermis, increased intrapapillary capillaries and marked basal hyperpigmentation were observed. The characteristic intracytoplasmic inclusion bodies were not observed in the epidermis (hematoxylin-eosin, original magnification 9100). (c) Fontana-Masson staining showed a small number of melanin blockade melanocytes in the upper and middle epidermis, and abundant melanocytes were found in the basal and suprabasal cells (940). (d) The patient showed complete regression of the extensive warts after 6 months.