Verruciform xanthoma is an uncommon benign lesion

Lesion

A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...

 that has a verruciform (wart

Wart

A wart is generally a small, rough growth, typically on a human’s hands or feet but often other locations, that can resemble a cauliflower or a solid blister. They are caused by a viral infection, specifically by human papillomavirus 2 and 7. There are as many as 10 varieties of warts, the most...

-like) appearance, but it may appear polypoid

Polyp (medicine)

A polyp is an abnormal growth of tissue projecting from a mucous membrane. If it is attached to the surface by a narrow elongated stalk, it is said to be pedunculated. If no stalk is present, it is said to be sessile. Polyps are commonly found in the colon, stomach, nose, sinus, urinary bladder...

, papilloma

Papilloma

Papilloma refers to a benign epithelial tumor growing exophytically in finger-like fronds. In this context papilla refers to the projection created by the tumor, not a tumor on an already existing papilla . When used without context, it frequently refers to infections caused by human...

tous, or sessile

Sessility (medicine)

In medicine, sessility is a characteristic of tumors and polyps that lack a stalk, as opposed to those that are pedunculated....

. Usually found on the oral mucosa

Oral mucosa

The oral mucosa is the mucous membrane epithelium of the mouth. It can be divided into three categories.*Masticatory mucosa, para-keratinized stratified squamous epithelium, found on the dorsum of the tongue, hard palate and attached gingiva....

 of middle-aged persons, verruciform xanthomas have also been reported on the scrotum

Scrotum

In some male mammals the scrotum is a dual-chambered protuberance of skin and muscle containing the testicles and divided by a septum. It is an extension of the perineum, and is located between the penis and anus. In humans and some other mammals, the base of the scrotum becomes covered with curly...

 and penis

Penis

The penis is a biological feature of male animals including both vertebrates and invertebrates...

 of middle-aged to elderly Japanese

Japanese people

The are an ethnic group originating in the Japanese archipelago and are the predominant ethnic group of Japan. Worldwide, approximately 130 million people are of Japanese descent; of these, approximately 127 million are residents of Japan. People of Japanese ancestry who live in other countries...

 males. While the most common site is the oral mucosa, lesions that occur elsewhere usually arise on the perineum

Perineum

In human anatomy, the perineum is a region of the body including the perineal body and surrounding structures...

 or on the skin with some predisposing factor, such as lymphedema or an epidermal nevus

Nevus

Nevus is the medical term for sharply-circumscribed and chronic lesions of the skin. These lesions are commonly named birthmarks and moles. Nevi are benign by definition...

.

Histology

A distinguishing feature of verruciform xanthoma is the presence of large numbers of lipid

Lipid

Lipids constitute a broad group of naturally occurring molecules that include fats, waxes, sterols, fat-soluble vitamins , monoglycerides, diglycerides, triglycerides, phospholipids, and others...

-laden foamy histiocyte

Histiocyte

A histiocyte is a cell that is part of the mononuclear phagocyte system . The mononuclear phagocytic system is part of the organism's immune system...

s in the lesion, and essentially limited to, the connective tissue

Connective tissue

"Connective tissue" is a fibrous tissue. It is one of the four traditional classes of tissues . Connective Tissue is found throughout the body.In fact the whole framework of the skeleton and the different specialized connective tissues from the crown of the head to the toes determine the form of...

 papillae in the lesion. The lesions are solitary, raised, or polypoid with cup-shaped craters filled with parakeratotic cells

Parakeratosis

Parakeratosis is a mode of keratinization characterized by the retention of nuclei in the stratum corneum. Parakeratosis: The orderly but abnormal keratinisation of cells so that the keratin layer consists of plump nucleated keratinised cells instead of annular squames...

 that blend into keratinocyte

Keratinocyte

Keratinocytes are the predominant cell type in the epidermis, the outermost layer of the human skin, constituting 95% of the cells found there. Those keratinocytes found in the basal layer of the skin are sometimes referred to as "basal cells" or "basal keratinocytes"...

s of an acanthotic

Acanthosis

Acanthosis is diffuse epidermal hyperplasia.Acanthosis implies increased thickness of stratum spinosum. It is a disease ofthe prickle cell layer of the skin, where warts appear on the skin or inside the mouth.-References:...

 and papillomatous epidermis. There is a neutrophilic infiltrate of varying intensity between plump parakeratotic cells and keratinocytes, near the surface of the epidermis.

Etiology

Verruciform xanthoma is most likely not a human papillomavirus

Human papillomavirus

Human papillomavirus is a member of the papillomavirus family of viruses that is capable of infecting humans. Like all papillomaviruses, HPVs establish productive infections only in keratinocytes of the skin or mucous membranes...

 associated lesion and the foam cells in the lesions are most likely derived from the monocyte

Monocyte

Monocytes are a type of white blood cell and are part of the innate immune system of vertebrates including all mammals , birds, reptiles, and fish. Monocytes play multiple roles in immune function...

—macrophage

Macrophage

Macrophages are cells produced by the differentiation of monocytes in tissues. Human macrophages are about in diameter. Monocytes and macrophages are phagocytes. Macrophages function in both non-specific defense as well as help initiate specific defense mechanisms of vertebrate animals...

 lineage. More research is needed is determine the etiology.

Symptoms

The most common location by far is the gingiva

Gingiva

The gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...

l margin and other areas of the masticatory

Mastication

Mastication or chewing is the process by which food is crushed and ground by teeth. It is the first step of digestion and it increases the surface area of foods to allow more efficient break down by enzymes. During the mastication process, the food is positioned between the teeth for grinding by...

 oral mucosa, these occur more frequently in the fifth decade of life, and have good prognosis, the treatment of choice for oral VXs is surgical excision

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, and recurrence is rare.

The condition can affect other organs of body, such as the penis

Penis

The penis is a biological feature of male animals including both vertebrates and invertebrates...

, vulva

Vulva

The vulva consists of the external genital organs of the female mammal. This article deals with the vulva of the human being, although the structures are similar for other mammals....

, and can occur in anal

Anus

The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...

 region, nose

Human nose

The visible part of the human nose is the protruding part of the face that bears the nostrils. The shape of the nose is determined by the ethmoid bone and the nasal septum, which consists mostly of cartilage and which separates the nostrils...

, the ear

Ear

The ear is the organ that detects sound. It not only receives sound, but also aids in balance and body position. The ear is part of the auditory system....

, lower extremity, scrotum

Scrotum

In some male mammals the scrotum is a dual-chambered protuberance of skin and muscle containing the testicles and divided by a septum. It is an extension of the perineum, and is located between the penis and anus. In humans and some other mammals, the base of the scrotum becomes covered with curly...

.

Differential diagnosis

Differential diagnosis

Differential diagnosis

A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...

 includes seborrheic keratosis

Seborrheic keratosis

A seborrheic keratosis is a noncancerous benign skin growth that originates in keratinocytes. Like liver spots, seborrheic keratoses are seen more often as people age. In fact they are sometimes humorously referred to as the "barnacles of old age". They appear in various colors, from light tan to...

, verruca simplex, condyloma acuminatum, granular cell myoblastoma, vulvar intraepithelial neoplasia

Vulvar intraepithelial neoplasia

The term Vulvar intraepithelial neoplasia refers to particular changes that can occur in the skin that covers the vulva. VIN is not cancer, and in some women it disappears without treatment...

, bowenoid papulosis

Bowenoid papulosis

Bowenoid papulosis is a cutaneous condition characterized by the presence of pigmented verrucous papules on the body of the penis. They are associated with human papillomavirus, the causative agent of genital warts...

, erythroplasia of Queyrat

Erythroplasia of Queyrat

Erythroplasia of Queyrat is a squamous cell carcinoma in situ of the glans penis.Like Bowen's Disease, it is associated with Human Papilloma Virus 16 and is a precursor for invasive squamous cell carcinoma.It is named for Louis Queyrat....

, and verrucous carcinoma

Verrucous carcinoma

Verrucous carcinoma is an uncommon variant of squamous cell carcinoma. This form of cancer is often seen in those who chew tobacco or use snuff orally, so much so that it is sometimes referred to as "Snuff dipper's cancer."Most patients with verrucous carcinoma have a good prognosis...