DERMATOPATHOLOGY CASES: Self-Assessment Cases: Editor - Dr Sampurna Roy MD

Digital Images of interesting cases that will include the full spectrum of Dermatopathology, presented in the form of quiz.

The answer of the cases include related links and recent abstracts of articles.

Sunday, December 13, 2009

Answer of Dermatopathology Case 14

Warty Dyskeratoma

Visit: Pathology of Warty Dyskeratoma
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Multiple warty dyskeratomas on the scalp. Dermatol Online J. 2009 Feb 15;15(2):8.
Warty dyskeratoma is usually characterized by solitary papules or nodules which reveal acantholytic dyskeratosis histopathologically. Warty dyskeratoma most commonly presents as a single lesion, but there are a few case reports of patients with multiple lesions. Herein we report a female patient presenting with multiple verrucous papules on the scalp diagnosed clinically and histopathologically as warty dyskeratoma.

Warty dyskeratoma: infundibular histogenesis. Anatomoclinical study of 43 cases. Ann Dermatol Venereol. 2007 Aug-Sep;134(8-9):633-6.
BACKGROUND: The exact origin and classification of warty dyskeratoma inepithelial tumours are still debated. The purpose of this study was to examinethe relationship between this tumour and the pilosebaceous follicles. MATERIALS AND METHODS: This was a retrospective, anatomoclinical study. Expression of cytokeratins 1, 5, 10, 17 and 19 was studied in ten of the samples using Immunohistochemistry techniques. RESULTS: We studied 43 cases of wartydyskeratoma in 42 patients of mean age 61 years. Lesions were described mainly as papular nodules (70%), in most cases keratotic (58%), with frequent centralumbilication (30%), and commonly located in the cervicocephalic region (65%). Histological examination frequently revealed a cupuliform aspect (77%), with numerous contiguous invaginated foci in 43% of cases. Less frequently, the lesions were superficial (12%) or nodular cystic (12%). In 72% of cases, at least one instance of follicular differentiation was seen. CK1 and CK10 were expressed in the suprabasal levels of the warty dyskeratoma while CK5 and CK17 were seen in the basal layers. CK19 was not expressed. DISCUSSION: Based on the histologicaland immunohistochemical findings, we proposed the hypothesis of benign epithelial tumour of follicular type, beginning in the pilar infundibulum.

Plaque form of warty dyskeratoma - acantholytic dyskeratotic acanthoma. J Cutan Pathol. 2007 Jun;34(6):494-6.
We report the case of a 64-year-old man with a plaque-like lesion on the lowerback. Clinically, squamous cell carcinoma was suspected, but the histologicalfeatures resembled those of isolated Darier's disease or pemphigus vegetans. The lesion was removed with the final diagnosis of acantholytic dyskeratotic acanthoma. We discuss this case with special regard to the differential diagnosis of other isolated acantholytic acanthomas.