VERRUCIFORM XANTHOMA: CASE SERIES OF AN UNUSUAL, COMMONLY MISDIAGNOSED LESION

Abstract

Introduction Verruciform Xanthoma (VX) is a benign condition occurring primarily in the oral cavity with some lesions also found on the genital mucosa or skin. VX occurs primarily in the fifth decade of life and shows a slight male predilection. This lesion generally presents as a papillary or rough-surfaced, painless, well-demarcated lesion, ranging from white, yellow-white, to orange in color. The etiology of VX is still largely unknown and definitive diagnosis is made based on histology. This lesion is thought to correlate with localized trauma or chronic inflammatory conditions such as lichen planus, lupus, epithelial dysplasia, pemphigus vulgaris, and mucous membrane pemphigoid. We report a series of three cases from our institution in which we examine the demographics associated with verruciform xanthoma as well as its connection to known inflammatory conditions. Patient Cases Our case series includes two males and one female patient ranging in age from 45-76 years old. The lesions were found in 3 different sites: gingival mucosa, ventral tongue, and buccal mucosa. Two of the patients had biopsy-proven oral lichen planus. The social and medical histories of each patient will be examined and compared for overlapping factors that may be of assistance in further clarifying demographic and etiological factors. Conclusion Clinicians should be familiar with verruciform xanthoma as it is often misdiagnosed as the more commonly occurring viral papilloma. Patients may be concerned they have contracted a viral disease and thus this lesion should be biopsied to rule out HPV infection.