1/32. The hyperkeratotic variant of disseminated superficial actinic porokeratosis (DSAP).A 78-year-old South Korean man was referred to us from the Medical intensive care Unit (MICU) for an opinion. He was comatose and was on ventilatory care due to aspiration pneumonia. Multiple tiny papules had developed 10 years previously and since then the number and size had been increasing gradually. He had been diabetic for the past 4 years, and had Parkinson's disease diagnosed 1 year previously. Laboratory examinations revealed an elevated level of white blood cells (WBCs) (25,000/microL) and decreased hemoglobin (8.8 g/dL). Other laboratory results were negative or within normal limits. skin examination showed multiple, discrete, crust-like, brownish papules over the erythematous base on the face, upper extremities, and lower extremities. With the clinical impressions of irritated verruca vulgaris, seborrheic keratosis, or cutaneous fungal infection, a skin biopsy was taken from a papule on the left shin, and histopathologic examination revealed several pronounced hyperkeratotic and parakeratotic columns, and characteristic cornoid lamellae in the stratum corneum. Beneath the cornoid lamellae, the granular layer was decreased. A number of round or oval, dyskeratotic, homogenized eosinophilic cells with pyknotic nuclei were scattered in the prickle cell layer below the cornoid lamellae. A mild lymphohistiocytic infiltrate was observed in the papillary dermis and around the blood vessels in the upper dermis. Also, actinic degeneration was present in the upper dermis.- - - - - - - - - - ranking = 1keywords = verruca (Clic here for more details about this article) |
2/32. Acral keratotic graft versus host disease simulating warts.A 55-year-old man experienced persistent oral graft versus host disease after receiving an HLA-matched allogeneic stem cell peripheral blood transplant for chronic myeloid leukaemia. Twelve months post-transplant, multiple keratotic lesions resembling warts developed on his fingers, on his palms and on the soles of his feet. skin biopsy showed a lichenoid reaction under a hyperplastic and hyperkeratotic epidermis lacking signs of papillomavirus infection. The lesions partially regressed when the patient's oral prednisone was increased. This instance of acral keratotic lesions may represent an unusual expression of chronic graft versus host disease; however, the the hydroxychloroquine which had been used for 8 months to control the patient's oral graft versus host disease cannot be excluded as a cofactor.- - - - - - - - - - ranking = 0.22638024772857keywords = wart (Clic here for more details about this article) |
3/32. Detection of human papillomavirus and response to topical 5% imiquimod in a case of stucco keratosis.Stucco keratosis is a skin disorder with papular warty lesions that usually appear on the lower limbs in elderly people. The aetiology, pathogenesis and treatment is still a matter of debate. We report a 75-year-old non-immunosuppressed man with extensive lesions all over his body, which had not responded to curettage or electrodesiccation. To determine the possible role of human papillomavirus (HPV) in stucco keratosis, we used nested polymerase chain reaction (PCR) to identify HPV dna in the lesions. To include a broad range of both cutaneous and mucosal HPV types, PCR was performed with two sets of degenerate primers. Using this approach we detected HPV types 9, 16, 23b, DL322 and a variant of HPV type 37 in multiple stucco keratoses. Imiquimod (5% cream), a new compound that modifies the immune response by stimulating production of cytokines, applied overnight, three times a week for 5 weeks, resulted in resolution of all treated lesions.- - - - - - - - - - ranking = 0.045276049545714keywords = wart (Clic here for more details about this article) |
4/32. Treatment of warty dyskeratoma with tazarotenic acid.A patient with warty dyskeratoma was successfully treated with tazarotenic acid gel. We present evidence to support that this did not occur by chance and suggest that tazarotenic acid be investigated further for the treatment of similar dyskeratatic disorders.- - - - - - - - - - ranking = 0.22638024772857keywords = wart (Clic here for more details about this article) |
5/32. Imiquimod to treat different cancers of the epidermis.BACKGROUND: Topical immunomodulatory therapy with imiquimod has been recently used for the treatment of actinic keratoses, intraepithelial carcinoma, and small basal cell carcinoma (BCC) besides the licensed indication of extragenital warts (condyloma). methods: We treated several patients with particular epidermal neoplasias such as squamous cell cancer (SCC) and basal cell cancer of sclerodermiform type three times per week for 4 to 12 weeks. RESULTS: We report several novel aspects of the treatment of epidermal cancers with self-applied, nonpainful, immunomodulatory therapy. First, we treated-for the first time-two immunosuppressed renal transplant patients for invasive SCC with imiquimod. Interestingly, systemic immunosuppression did not adversely affect the response to therapy. Second, one patient with the high-risk and aggressive growth pattern of basal cell cancer (sclerodermiform histology) was cured from his disease at a particular location in the face, suggesting sufficient penetration despite scarring. No recurrence was detected in another patient who suffered from 29 BCCs until almost 2-years follow-up. Third, the treatment of actinic keratoses in the face is substantially shorter (in the order of 4 to 6 weeks) as opposed to other skin cancers. Immunomodulatory treatment with imiquimod led to the demarcation of in situ actinic keratosis lesions that could not be identified using the dermatologist's experience, probably because of the existence of exclusive alterations on the molecular level. CONCLUSION: Several novel aspects of immunomodulatory treatment with imiquimod and new indications such as selected cases of sclerodermiform BCC and SCC have been described. The texture of the skin at various different body locations may explain the varying sensitivities to imiquimod when facial skin is compared with skin on the extremities.- - - - - - - - - - ranking = 0.045276049545714keywords = wart (Clic here for more details about this article) |
6/32. Keratosis lichenoides chronica mimicking verrucous secondary syphilis.Keratosis lichenoides chronica is a rare dermatosis of unknown etiology with a wide variety of cutaneous manifestations. We present a 47-year-old male with a history of progressive and recalcitrant hyperkeratotic and warty plaques, mimicking verrucous secondary syphilis both clinically and microscopically. We review the clinical manifestations, microscopic features, and treatment modalities for this rare and distinctive dermatosis.- - - - - - - - - - ranking = 0.045276049545714keywords = wart (Clic here for more details about this article) |
7/32. Seborrheic keratosis: an acantholytic variant.Two elderly women with seborrheic keratoses on the abdomen are reported on because of the peculiar histologic appearance characterized by prominent acantholysis. Although the basic histologic architecture was a papillomatous acanthoma corresponding to that of seborrheic keratosis, the upper portion of the lesions showed extensive acantholytic changes and dyskeratotic cells. Differentiation from seborrheic keratosis with focal acantholytic dyskeratosis, warty dyskeratoma, keratosis senilis and acantholytic squamous cell carcinoma could be made on the basis of clinical as well as histological features. Although the histogenesis is uncertain, it seems logical to propose that this is a rare variant of irritated seborrheic keratosis.- - - - - - - - - - ranking = 0.045276049545714keywords = wart (Clic here for more details about this article) |
8/32. Florid cutaneous papillomatosis.The abrupt onset of acanthosis nigricans (AN) or of multiple seborrheic keratoses in middle-aged or older people is often associated with underlying malignant neoplasms. We describe a 64-year-old woman who developed a large number of verrucous papillomas on the trunk and extremities, followed within a few months by the sudden appearance of both the lesions of AN and those of multiple seborrheic keratoses. laparotomy disclosed a gastric adenocarcinoma. A number of similar cases have been described in the literature. It is emphasized that patients with suddenly appearing verrucous papillomas should be examined carefully for an underlying cancer. To call attention to this eruption, which may be mistaken for generalized warts, we suggest the term "florid cutaneous papillomatosis".- - - - - - - - - - ranking = 0.045276049545714keywords = wart (Clic here for more details about this article) |
9/32. Acrokeratosis verruciformis of Hopf (Hopf disease): case report and review of the literature.Acrokeratosis verruciformis of Hopf is an autosomal dominant genodermatosis usually presenting with multiple planar wart-like lesions, typically observed on the dorsum of the hands and feet. The disease is very rare and the pathogenesis remains unknown. Considerable controversy surrounds the nature and relationship of acrokeratosis and darier disease and whether they are manifestations of one genetic abnormality. We describe the case of a 19-year-old man seen in our clinic with skin-coloured, flat, warty papules localized to the dorsum of the hands and feet. Both clinical and histological findings were compatible with acrokeratosis verruciformis. We also review the disease, particularly its relation with Darier disease and therapeutical options.- - - - - - - - - - ranking = 0.090552099091429keywords = wart (Clic here for more details about this article) |
10/32. Clinical and histopathological findings in Bannayan-Riley-Ruvalcaba syndrome.Bannayan-Riley-Ruvalcaba syndrome is a rare autosomal dominant genodermatosis with the classical triad of macrocephaly, genital lentiginosis, and intestinal polyposis. Characteristic mucocutaneous manifestations include vascular malformations, lipomatosis, speckled lentiginosis of the penis or vulva, facial verrucae-like or acanthosis nigricans-like lesions, and multiple acrochordons of the neck, axilla, and groin. We present a case of Bannayan-Riley-Ruvalcaba syndrome with macrocephaly, abnormal facies, lipoma, tender and painful arteriovenous hemangiomas, lymphangiokeratomas, musculoskeletal abnormalities, and localized myopathy. We also describe previously unreported findings, including peripheral neuropathy, punctate cystic changes in acral tubular bones, and enostosis of talus. Bannayan-Riley-Ruvalcaba syndrome needs recognition by dermatologists because affected patients may present with mucocutaneous and subcutaneous lesions that may simulate other dermatological disorders.- - - - - - - - - - ranking = 1keywords = verruca (Clic here for more details about this article) |
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