Management of cutaneous verruciform xanthoma

Verruciform xanthoma is an uncommon mucocutaneous condition of uncertain ca use that only occasionally affects the skin. The histopathology is distinct ive for the presence of foamy histiocytes present within elongated dermal p apillae. Although simple excision of intraoral lesions is reportedly curati ve, treatment of cutaneous lesions has not been previously reported. We des cribe a 62-year-old man with a large lesion of verruciform xanthoma affecti ng both inguinal folds. Immunohistochemical staining, reverse transcriptase polymerase chain reaction for human papilloma virus, and ultrastructural a nalysis were performed to investigate the pathogenesis of this lesion. The results of these studies support the theory that the source of lipid in der mal histiocytes is degenerating keratinocytes. Initial treatment with wire loop electrosection, pulsed dye (585 nm) laser, and x-ray therapy of this p atient proved unsuccessful. Preliminary success has been achieved using wid e surgical excision with primary closure.