Wart on fire: A rare entity of verruciform xanthoma arising on a lower leg in a setting of chronic lymphedema

Roy, Simon F.; Prokopetz, Robert; Ayroud, Yasmine; Pickett, Laura; Litvinov, Ivan V.

doi:10.1016/j.jdcr.2016.12.002

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…Then, the histopathological analysis is required for diagnosis of oral verrucous xanthoma, especially in smoker patients presenting white verrucous lesions on the tongue or floor of mouth. Microscopically, the presence of verrucous proliferation of squamous epithelium with elongated rete ridges and markedly thickened parakeratin associated with macrophages with foamy cytoplasm due to the presence of lipids (xanthoma cells) are classical morphologic characteristics found in xanthoma ( 9 ), such as observed in present cases reported. The immunohistochemical stains, including positivity for CD68, CD63, or CD163, as used in one of our patients, are not essential for the diagnosis of oral xanthoma but contribute to confirm the macrophage origin of the foamy cells ( 4 ).…”

Section: Discussionsupporting

confidence: 71%

“…The lesion was surgically excised, and the material sent for histopathological analysis. Microscopic sections, stained in hematoxylin and eosin, revealed prominent papillary lesion showing abundant keratin on surface of the hyperplastic oral squamous stratified epithelium forming elongated rete pegs, typically described as “wart on fire” ( 9 ) (Fig. 1 B).…”

Section: Case Reportmentioning

confidence: 99%

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Oral verruciform xanthomas mimicking potentially malignant disorders

Preto,

Lopes-Santos,

Zanda

et al. 2024

J Clin Exp Dent

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Verruciform xanthoma represents a reactive lesion, common in the skin and somewhat rare in the mouth. Cases description: Two cases of verrucous white plaques, located on the tongue and the floor of mouth of different 30-years-old man and woman and clinically diagnosed as leukoplakia, are described. The histopathological analyses confirmed the diagnosis of oral verruciform xanthomas for both lesions. Practical implications: Despite of uncommon in the oral cavity, the verruciform xanthoma, particularly when affecting regions with a higher risk of developing oral cancer, should be included in differential diagnosis of oral potentially malignant disorders. The histopathological analysis remains as “gold standard technique” for a more accurate diagnosis of oral verruciform xanthoma. Key words: Foam cells, Verruciform xanthoma, Leukoplakia, Tongue.

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Section: Discussionsupporting

confidence: 71%

Section: Case Reportmentioning

confidence: 99%

Oral verruciform xanthomas mimicking potentially malignant disorders

Preto,

Lopes-Santos,

Zanda

et al. 2024

J Clin Exp Dent

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“…Among the various histopathological features, a sharply demarcated parakeratin layer exhibiting clear orange color and forming epidermal crypt has been considered diagnostic of verruciform xanthoma . The term “wart on fire” was proposed to describe this characteristic feature .…”

Section: Discussionmentioning

confidence: 99%

Verruciform xanthoma accompanying a cystic growth: A case report

et al. 2019

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“…Verruciform xanthoma (VX) of the oral cavity is an uncommon, reactive lesion that was first described in 1971 by Shafer [1]. Rare extraoral VX, which occur on the skin and anogenital mucosa, have also been reported [2][3][4][5][6]. Buchner et al reported an incidence rate of 0.025-0.095% for oral VX within a 12 year period [7].…”

Section: Introductionmentioning

confidence: 99%

Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature

Belknap

Islam

Bhattacharyya

et al. 2020

Head and Neck Pathol

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Verruciform xanthoma (VX) of the oral cavity is an uncommon, reactive lesion of unknown etiology. In this study, we present a large series of VX with analysis of demographics, clinical appearance, histologic presentation and extensive review of literature. To the best of our knowledge, this is the largest series of oral VX reported to date. Following IRB approval, all cases diagnosed as VX found in the archives of the University of Florida Oral Pathology Biopsy Service were included. Patient age, gender, location, clinical appearance, clinical impression, and duration of each lesion was collected. A total of 212 cases were included in our database with a mean age of 61 years (range of 9-94), and a female: male ratio of 1.06:1. The most common location in descending order was the gingiva (n = 110, 51.2%), followed by palate (n = 41, 19.3%), buccal mucosa (n = 18, 8.5%), tongue (n = 20, 9.4%), vestibule (n = 13, 6.1%), lip (n = 4, 1.9%), floor of mouth (n = 3, 1.4%), and unspecified (n = 1, 0.5%). The lesions were most frequently pink in color, and most often described as bumpy, rough, verrucoid and/or papillary. Clinical impression in descending order was papillary (n = 67, 31.6%), not specified or unknown (n = 41, 19.3%), hyperkeratosis (n = 24, 11.3%), fibroma (n = 20, 9.4%), leukoplakia (n = 17, 8.0%), dysplastic lesion (n = 13, 6.1%), pyogenic granuloma (n = 7, 3.3%), granulomatous reaction (n = 5, 2.4%), lichen planus, VX (n = 4 each, 2.0%), pigmented, other lesions (n = 3 each, 1.4%), and salivary and periapical lesions (n = 2 each, 0.9%). Three of the lesions were recurrences. The demographics and clinical parameters of this case series were in concordance with that of previously published reports. In our series, only 4 cases were suspected as VX, demonstrating the lack of familiarity clinicians have with this lesion.

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Wart on fire: A rare entity of verruciform xanthoma arising on a lower leg in a setting of chronic lymphedema

Cited by 8 publications

References 12 publications

Oral verruciform xanthomas mimicking potentially malignant disorders

Oral verruciform xanthomas mimicking potentially malignant disorders

Verruciform xanthoma accompanying a cystic growth: A case report

Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature

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