Warty dyskeratoma; A rare entity with involvement of multiple adjoining follicles

Abstract

Warty dyskeratoma is a rare epidermal tumor which occurs in middle aged or older persons, clinically manifests as papule or nodule and involves head and neck region in most of the cases. 65y F presented to the OPD with complaint of nodular swelling over the right cheek with itching for 15 years. On clinical examination patient had 3x1.8 cm nodule, firm in consistency, mobile, with ulceration over tumor. Routine investigations were within normal limits and Fine Needle Aspiration Cytology was reported as suspicious of malignancy. Histopathology of excised mass revealed hyperkeratotic, parakeratotic and acanthotic epidermis show large multiple invaginations comprising of lacunae along with villi formation. Stratum corneum and upper malpighi layer shows abundant dyskeratotic acantholytic cells. As per literature these changes are usually noticed in single hair follicle. Here we describe a rare case of warty dyskeratoma with multiple adjacent hair follicles involvement.