Premium
Genital verruciform xanthoma: lessons from a contemporary multi‐institutional series
Author(s) -
Wang Grace,
Mochel Mark C,
Randall M Barry,
Gandhi Jatin S,
Udager Aaron M,
Chan May P,
Patel Rajiv M,
Amin Mahul B,
Osunkoya Adeboye O,
Smith Steven C
Publication year - 2020
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.14198
Subject(s) - scrotum , vulva , medicine , sex organ , dermatology , parakeratosis , perineum , cohort , lesion , pathology , xanthoma , penis , surgery , biology , genetics
Aims Verruciform xanthoma (VX) is an uncommon lesion, seen in the oral mucosa and rarely occurring at cutaneous genital sites. Reports of exceptional VX presentations dominate the literature; herein, we assess the clinical and histological features of a cohort of routine, consecutive cases. Methods and results Clinicopathological features of genital VXs from four academic centres were reviewed. A cohort of 25 lesions from 24 patients (22 male, two female; median age = 62 years), occurred on the scrotum (84%), penis (8%) and perineum/vulva (8%). VX was never suspected clinically; considerations ranged from fibroepithelial polyps to squamous cell carcinoma. Classic diagnostic criteria were present at least focally in each lesion, including verrucous architecture, prominent wedge‐shaped parakeratosis extending between exophytic epidermal projections and neutrophils in the stratum corneum. Xanthomatous cells were present in all cases, but scattered to rare in 24%. Conclusions Consecutive genital VXs reliably exhibited classic histopathological features, although the essential finding of xanthomatous cells may be scarce. Our comparison to meta‐analyses of published cases found relatively fewer penile and vulvar examples. Additionally, the median age was older than in published series, which have emphasised syndromic associations.