Langerhans cells in verruciform xanthomas: an immunoperoxidase study of 10 oral cases

Abstract

Ten oral verruciform xanthomas were studied using an immunoperoxidase stain for S‐100 protein. All cases exhibited positively stained dendritic cells among the mononuclear inflammatory cell infiltrate at the base of the lesions and to a lesser extent among the “foam cells”. The foam cells were, however, negative for S‐100 staining. We suggest that, based on these findings, verruciform xanthomas belong to a new category of “non‐X histiocytoses” in which the presence of Langerhans cells suggests an immunologic pathogenesis.

Oral Verruciform Xanthoma Associated with Chronic Graft-Versus- Host Disease: A Report of Five Cases and a Review of the Literature

“…Immunologic factors [39] and viral etiologies [5] have been also suggested. The prevailing theory is that epithelial tissue damage results in the breakdown of the phospholipid-rich cell membranes releasing lipids that are then taken up by macrophages in the connective tissue that become lipidladen or foamy in appearance [38,40,41].…”

“…The prevailing theory is that epithelial tissue damage results in the breakdown of the phospholipid-rich cell membranes releasing lipids that are then taken up by macrophages in the connective tissue that become lipidladen or foamy in appearance [38,40,41]. An immunologic pathogenesis has been suggested because of the predominant T cells infiltrate, and decreased number of Langerhans cells in oral VX compared to normal tissue [34,39]. Human papillomavirus (HPV) has not been demonstrated in VX lesions [24,26,35,41,42] and viral particles have not been identified ultrastructurally [35].…”

Verruciform xanthoma: A view on the concepts of its etiopathogenesis

“…[9] The negativity of these cells to S-100 ruled out the possibility of the origin of these xanthoma cells from dermal dendritic cells. [13]…”

Verruciform xanthoma: case report

“…The pathogenic mechanisms reported in the literature for VX comprise inflammation, virus, local trauma, lipid metabolism disorders and immunological changes 7,12,15 .…”

“…The authors suggested that an immune response could play an important role in the pathogenesis of VX. Rowden et al 15 demonstrated the presence of Langerhans cells in VX lesions by the positive marking of S-100, suggesting a possible immunological component in the pathogenesis of VX. Mostafa et al 23 suggested that VX could be a local immunological disorder mediated by T cells.…”