Transcript CASE 33 Alejandro García-Varona, MD Hospital El Bierzo Initial Presentation and Management • 34 year-old female • No relevant individual or family medical history • At her annual.

CASE 33
Alejandro García-Varona, MD
Hospital El Bierzo
Initial Presentation and
Management
• 34 year-old female
• No relevant individual or family medical
history
• At her annual pap test screening visit, her
doctor noted a single, asymptomatic, discrete,
cystic (kind of papillary) lesion on her left labia
majora, about 0,3 cm
Initial Presentation and
Management
• She told the patient and performed a biopsy
of the lesion
• We received an irregular, reddish, cutaneous
fragment, 0,5 cm
DIAGNOSIS
WARTY DYSKERATOMA
Warty Dyskeratoma
• Benign papulo-nodular lesion with an
endophytic proliferation of squamous
epithelium, often in relation to a
foliculosebaceous unit and showing
prominent acantholytic dyskeratosis
• Unknown etiology. Unrelated to HPV
• Typically involves head and neck. Oral,
laryngeal and vulval location have been
reported
Warty Dyskeratoma
• Solitary pink/brown papules, nodules or cysts
with an umbilicated or pore-like centre or
central keratin plug
• Between 1 and 10 mm
Jang EJ, et al. Ann Dermatol 2011;23:98-100
Warty Dyskeratoma
• Well-demarcated endophytic lesion
• Abundant keratin that forms a plug in the
center
• Superficial keratinous debris contains
conspicuous corps ronds
• Prominent acantholytic dyskeratosis
• Suprabasal clefting with villi formation
• Underlying dermis with lymphocytic infiltrate
Warty Dyskeratoma
• Common mitotic figures
• Three variants:
– Cup-shaped
– Cystic
– Nodular
• Epidermal collarette present
• Connection to folliculosebaceous structure is
commonly demonstrable
Warty Dyskeratoma
• DD with comedonal Darier disease (similar
histology, differentiated on clinical grounds)
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