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Perineal verrucous carcinoma is a rare variant of squamous cell carcinoma that is mainly treated with surgical excision. In this case report, we present a 58-year-old man with human immunodeficiency virus who presented with an extraordinarily large perineal mass that was ultimately found to be verrucous carcinoma in association with giant condyloma acuminata. He was treated with a wide local excision followed by staged abdominoperineal resection and fasciocutaneous flap reconstruction. In the post-operative course, the patient developed relatively short interval recurrence which was successfully managed with salvage radiotherapy. He is now post-radiation without evidence of recurrence. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Herpes simplex virus (HSV) infection can present atypically in immunosuppressed patients, such as renal transplant recipients, often mimicking conditions like condyloma acuminata. This case report of a 39‐year‐old male renal transplant recipient underscores the importance of maintaining a high level of clinical suspicion and employing thorough diagnostic techniques, including skin biopsy and polymerase chain reaction, to accurately diagnose chronic lesions and those not responding to initial therapies in these patients. Timely initiation of antiviral therapy, such as intravenous acyclovir, is crucial for improving patient outcomes. Clinicians should be aware of the diverse presentations of HSV in immunocompromised individuals to ensure prompt and effective treatment. Herpes simplex virus (HSV) has a worldwide distribution and a wide range of clinical presentations. In immunosuppressed patients, the infection can have atypical presentations. We report a 39‐year‐old renal transplant recipient male with a cutaneous HSV infection mimicking condyloma acuminata. The diagnosis was confirmed by skin biopsy and polymerase chain reaction. The patient was treated with intravenous acyclovir. This case illustrates the significant clinical challenges in establishing a correct diagnosis of this common infection in these patients. A high level of clinical suspicion will result in a prompt diagnosis and timely initiation of antiviral therapy, which is crucial to better patient outcomes. [ABSTRACT FROM AUTHOR]

Bowen's disease is under-recognised, in situ - squamous cell carcinoma usually presenting as a single, well demarcated, slow growing erythematous patch or plaque with a scaly or crusted surface. It has a limited potential of invasion. It mainly occurs over the sun-exposed parts of the body (typical variant). Genitals, back, finger, trunk & thigh are the peculiar sites for pigmented, verrucous, atrophic & hyperkeratotic variants which are considered as atypical variants. A total of 3 patients (2 males and 1 female; average age: 57 years) were noted over a span of one year. Rarity, atypical variants and limited case series on Bowen disease in literature prompt us to report this interesting case series.

Key Clinical Message Herpes simplex virus (HSV) infection can present atypically in immunosuppressed patients, such as renal transplant recipients, often mimicking conditions like condyloma acuminata. This case report of a 39‐year‐old male renal transplant recipient underscores the importance of maintaining a high level of clinical suspicion and employing thorough diagnostic techniques, including skin biopsy and polymerase chain reaction, to accurately diagnose chronic lesions and those not responding to initial therapies in these patients. Timely initiation of antiviral therapy, such as intravenous acyclovir, is crucial for improving patient outcomes. Clinicians should be aware of the diverse presentations of HSV in immunocompromised individuals to ensure prompt and effective treatment. Abstract Herpes simplex virus (HSV) has a worldwide distribution and a wide range of clinical presentations. In immunosuppressed patients, the infection can have atypical presentations. We report a 39‐year‐old renal transplant recipient male with a cutaneous HSV infection mimicking condyloma acuminata. The diagnosis was confirmed by skin biopsy and polymerase chain reaction. The patient was treated with intravenous acyclovir. This case illustrates the significant clinical challenges in establishing a correct diagnosis of this common infection in these patients. A high level of clinical suspicion will result in a prompt diagnosis and timely initiation of antiviral therapy, which is crucial to better patient outcomes.

Objective: To investigate epidemiological, clinical and oncological outcomes of patients with laryngeal verrucous carcinomas (LVC). Methods: Two independent authors investigated PubMed, Scopus and Cochrane Library for studies dedicated to epidemiological, clinical and oncological outcomes of patients with LVC. The following outcomes were investigated with PRISMA criteria: age; gender; tobacco/alcohol consumption; HPV infection; anatomical, pathological, therapeutic and survival outcomes. Studies were analyzed for bias through a validated clinical tool. Results: Of the 212 identified articles, 15 retrospective studies and one prospective uncontrolled study met our inclusion criteria. Three studies reported findings from national databases. The males/females ratio is 9/1. Mean age was 60.3 years, which was younger compared to other laryngeal malignancies. The alcohol, cigarette overuse and the HPV status of patients were lacking in most studies. Glottis and supraglottis were the most common anatomical locations, corresponding to 78.7% and 12.4% of cases, respectively. The main therapeutic approaches consisted of surgery, radiotherapy, surgery followed by radiotherapy. Treatments reported 5-year overall survival and disease-specific survival of 86.3 and 90.8, respectively. The 5- and 10-year local control rate were 83.6 and 72.6, respectively. The 10-year disease-specific survival was 80.2. Heterogeneity between studies was found for inclusion criteria, comorbidity data, and treatments. Conclusion: LVC is a rare laryngeal cancer associated with better survival and recurrence outcomes than laryngeal squamous cell carcinoma. The role of radiotherapy in the treatment regimen needs to be investigated in future prospective controlled studies. [ABSTRACT FROM AUTHOR]

Introduction: Verruco papillary lesions (VPL) in the oral cavity encompass a spectrum of lesions starting from benign, potentially malignant to entirely malignant tumors. Much of the controversies in these entities occur due to lack of consensus on the disease characteristics and the management. This systematic review was conducted to identify and describe different lesions categorized as VPL in the oral cavity and their association with malignancy. Methods: An electronic literature search was conducted in MEDLINE (via PubMed), Scopus, LILAC, IMSEAR, and CENTRAL databases, which retrieved a total of 1020 abstracts. These abstracts were managed through Rayyan and Mendeley software, and only 28 studies with high quality were included in the systematic review. Results: Studies were published from 1992 to 2021. From the extracted data, nine different entities under the umbrella term VPL were identified associated with malignancy. We describe the clinical and histopathological characteristics of these and propose a uniform framework for nomenclature. Conclusions: Lack of well‐planned research with adequate follow‐up duration and inadequate quality standards are major barriers for the lack of evidence. The use of uniform nomenclature, as proposed in this study, and research at the molecular level will greatly reduce the controversies in understanding oral VPL associated with malignancy. [ABSTRACT FROM AUTHOR]

Background: Marjolin's ulcer is the malignant degeneration of any chronic wound, with a latency period from tissue injury to variable malignant transformation that may occur up to 30 years later. Among the associated neoplasms, squamous cell carcinoma (SCC) is the predominant lineage in up to 71% of cases. The verrucous carcinoma variant has been estimated to have a low presentation, being described in the literature as 2% of all SCC and reported anecdotally in immunosuppressed patients, which justifies the objective of this publication. Clinical case: 65-year-old female patient with a history of being a carrier of human immunodeficiency virus (HIV) infection, who presented a verrucous carcinoma associated to a Marjolin ulcer secondary to herpes zoster and infection of soft tissues in the right leg, with a latency period of 10 years from the initial infectious process to histopathological confirmation. Conclusions: The finding of a verrucous carcinoma on a Marjolin ulcer has been little described in literature, with a lower incidence in the context of a patient with a history of being a carrier of HIV infection, finding 7 case reports, the oldest from 1998. For this reason, it is important to have diagnostic suspicion, to carry out an adequate study protocol and always making clinical-pathological correlation, in order to establish timely and individualized treatment. [ABSTRACT FROM AUTHOR]

Background: Squamous verrucous proliferative lesions of oral cavity can pose a diagnostic challenge for the general pathologist, especially on small biopsies. The superficial nature of incisional biopsies and inconsistent histologic terminologies used for these lesions contribute to often-discrepant clinical diagnosis, resulting in delayed treatment. This study aims to explore the proliferative squamous lesions of oral cavity, correlate biopsy & resection diagnoses, and evaluate possible reasons for discrepant diagnosis (if any). Design: A retrospective review of oral verrucous squamous lesions was undertaken. Pathology database was searched for oral cavity biopsies from January2018 through August2022 with the keywords: atypical, verrucous, squamous, and proliferative. Cases with follow-up were included in this study. A blinded review of the biopsy slides was performed and documented by a single head and neck pathologist. Demographic data, biopsy and final diagnosis were recorded. Results: Twenty-three cases met criteria for inclusion. The mean patient age was 61.1 years with a male: female ratio of 1.09. Most frequent site was lateral border of tongue (36%) followed by buccal mucosa and retromolar trigone. The most common biopsy diagnosis was "Atypical squamoproliferative lesion, excision recommended" (n = 16/23, 69%) with 13/16 showing conventional squamous cell carcinoma (SCC) on follow-up resection. 2/16 atypical cases underwent repeat biopsy for confirmation of diagnosis. Overall, conventional SCC was the most prevalent final diagnosis (73%, n = 17), followed by verrucous carcinoma (17%, n = 4). On slide review, six initial biopsies were reclassified as SCC, while one final diagnosis was reclassified as a hybrid carcinoma (on resection specimen). Diagnostic concordance (biopsy and resection) was observed in three cases, all three were recurrences. The primary reasons for discrepant diagnosis on initial biopsies were found to be 1. Obscuring inflammation, 2. Superficial biopsies, and 3. Under recognition of morphologic features (e.g., tear shaped rete, loss of polarity, dyskeratotic cells, paradoxical maturation) that help differentiate dysplasia from reactive atypia. Conclusion: This study highlights the rampant interobserver variability in diagnosis of oral cavity squamous lesions and emphasizes importance of identifying morphologic clues that can aid in correct diagnosis, thereby helping in adequate clinical management. [ABSTRACT FROM AUTHOR]

Huixian Li,1 Hui Li,2 Qinghua Tian,2 Xiangang Fang2 1Department of Sterilization Supply, Weifang People’s Hospital, Weifang, Shandong, People’s Republic of China; 2Department of Dermatology, Weifang People’s Hospital, Weifang, Shandong, People’s Republic of ChinaCorrespondence: Xiangang Fang, Department of Dermatology, Weifang People’s Hospital, 151 Guangwen Street, Weifang, Shandong, 261041, People’s Republic of China, Tel +86-536-8192561, Email sdlntszqjlb@163.comAbstract: Granular parakeratosis is a rare dermatosis characterized by erythematous scaly patches or papules, and plaques, often involving intertriginous areas. In this work, a 73-year-old Chinese male patient presented with a 6-month history of pruritic verrucous papules on the bilateral groin. A skin biopsy was performed and revealed the following: the horny layer showed highly compact hyperkeratosis and parakeratosis with basophilic granules; the epidermis showed obvious acanthosis with psoriasiform hyperplasia. The final diagnosis was verrucous granular parakeratosis. We also reviewed the progress in nomenclature, etiology, clinical manifestations, differential diagnosis and treatment. Different clinical manifestations may represent different clinical entities. Dermatologists should differentiate it from other diseases to make a correct diagnosis. Treatment options should be based on the variable etiologies and clinical manifestations.Keywords: granular parakeratosis, verrucous, papule, groin, glucocorticoid, tretinoin

Abstract Purpose Divided nevus with verrucous hyperplasia will always recur after surgery but non-verrucous divided eyelid nevus rarely recur. This study analyzed the differential expression of Ki-67, S100, Melan A and HMB45 and identified the correlation between the clinical and histopathological features of verrucous and non-verrucous divided eyelid nevus. Methods This study included 29 patients, of whom 8 patients had verrucous divided nevus. Immunohistochemistry labeling was used to assess the expression of Ki-67, S100, Melan A and HMB45 after excision. The difference between verrucous and non-verrucous divided eyelid nevus was analyzed. Results The patients’ ages ranged from 2 to 59 years, with a mean age of 19 years. The lesion size ranged from 1.5 to 2.0 cm in diameter and invaded the eyelid margins and the posterior lamella of the eyelids. Immunohistochemistry labeling showed strong positivity for approximately 98.5% of S100 and positive staining for approximately 27.6% of Ki-67, 72.4% of Melan A and 6.8% of HMB45. However, Ki-67 was significantly upregulated in verrucous divided nevus of the eyelids compared with non-verrucous divided nevus, with approximately 38.8% upregulation in verrucous and 18.3% upregulation in non-verrucous nevus. Conclusions This study correlated the clinic-pathologic features of verrucous divided eyelid nevus by means of statistically analyzing the varied clinical features and pathological impressions. The significant over-expression of S100 may be used as an indicator of divided nevus of the eyelids, and the over-expressed Ki-67 may contribute to the recurrence of verrucous divided nevus. High expression of HMB45 and Melan A may represent malignant transformation.

Purpose: Divided nevus with verrucous hyperplasia will always recur after surgery but non-verrucous divided eyelid nevus rarely recur. This study analyzed the differential expression of Ki-67, S100, Melan A and HMB45 and identified the correlation between the clinical and histopathological features of verrucous and non-verrucous divided eyelid nevus.Methods: This study included 29 patients, of whom 8 patients had verrucous divided nevus. Immunohistochemistry labeling was used to assess the expression of Ki-67, S100, Melan A and HMB45 after excision. The difference between verrucous and non-verrucous divided eyelid nevus was analyzed.Results: The patients' ages ranged from 2 to 59 years, with a mean age of 19 years. The lesion size ranged from 1.5 to 2.0 cm in diameter and invaded the eyelid margins and the posterior lamella of the eyelids. Immunohistochemistry labeling showed strong positivity for approximately 98.5% of S100 and positive staining for approximately 27.6% of Ki-67, 72.4% of Melan A and 6.8% of HMB45. However, Ki-67 was significantly upregulated in verrucous divided nevus of the eyelids compared with non-verrucous divided nevus, with approximately 38.8% upregulation in verrucous and 18.3% upregulation in non-verrucous nevus.Conclusions: This study correlated the clinic-pathologic features of verrucous divided eyelid nevus by means of statistically analyzing the varied clinical features and pathological impressions. The significant over-expression of S100 may be used as an indicator of divided nevus of the eyelids, and the over-expressed Ki-67 may contribute to the recurrence of verrucous divided nevus. High expression of HMB45 and Melan A may represent malignant transformation. [ABSTRACT FROM AUTHOR]

Abstract Background Verrucous vulvar carcinoma (VC) is an uncommon and distinct histologic subtype of squamous cell carcinoma (SCC). The available literature on VC is currently limited to case reports and small single institution studies. Aims The goals of this study were to analyze data from the National Cancer Database (NCDB) to quantitate the incidence of VC and to investigate the effects of patient demographics, tumor characteristics, and treatment regimens on overall survival (OS) in women with verrucous vulvar carcinoma. Methods and results Patients diagnosed with vulvar SCC or VC between the years of 2004 and 2016 were identified in the NCDB. OS was assessed with Kaplan–Meier curves and the log‐rank test. Construction of a Cox model compared survival after controlling for confounding variables. The reported incidence of SCC of the vulva has significantly increased since 2004 (p

Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC) that is characterized by minimal cytologic atypia and a unique deeply infiltrative growth pattern resembling rabbit burrows (cuniculi). With less than 75 cases reported in the head and neck, the clinical and pathologic spectrum of this entity remains poorly understood. A retrospective review of the clinical and pathologic features of archival cases of oral CC was performed. A total of six cases of oral CC were identified. Age ranged from 25-77 years; the male-to-female ratio was 5:1. All patients had a long-standing history of tobacco and betel-quid consumption. The tumors were distributed in the gingivobuccal sulcus (n = 2), the tongue (n = 2), buccal mucosa (n = 1), and the palate (n = 1). Histology in all cases typically revealed a tumor composed of well-differentiated squamous epithelium, devoid of atypia, lining deeply infiltrative, large-sized, branching, keratin-filled cavities, resembling rabbit-burrows. Dense lymphocytic infiltrates and discharging micro-abscesses were regular features. Underlying bone invasion and lymph node metastasis were observed in 1 patient. One patient with a tongue tumor developed locoregional recurrence at 10 months while none developed distant metastasis. Oral CC is a rare and under-recognized variant of SCC with locally aggressive behavior. Lack of familiarity with this variant exacerbated by the absence of cytologic anaplasia makes CC susceptible to multiple negative biopsies and erroneous diagnoses. Awareness of this clinicopathologic entity is essential to allow its accurate diagnosis and optimal management. [ABSTRACT FROM AUTHOR]

Abstract Various clinical forms of cutaneous leishmaniasis can be encountered such as: ulcerated, lupoïd, sporotrichoïd and other rare forms (eczematiform, erysipeloid, psoriasiform, verrucous, and pseudotumoral). We report an atypical presentation of verrucous and pseudotumoral cutaneous leishmaniasis that resolved following a course of cryotherapy.

Background: Oral verrucous lesions (OVLs) present a diagnostic challenge due to their diverse and often confusing histopathological features. Accurate differentiation is essential for improving diagnosis and predicting prognosis. In addition to assessing overall survival (OS) and disease-free survival (DFS) in verrucous squamous cell carcinoma (VSCC) and conventional OSCC, this study seeks to evaluate the expression of Mcm-2 and Ki-67 in verrucous lesions and oral squamous cell carcinoma (OSCC). These findings will be correlated with the nuclear expression of Mcm-2 and Ki-67., Methodology: Ninety tissue samples that were paraffin embedded and formalin-fixed were examined using immunohistochemistry to determine the expression of Mcm-2 and Ki-67. Data on survival and clinico-pathologic characteristics were taken from patient records. Statistical analyses were conducted using Independent T-tests, Cox regression models, and Kaplan-Meier survival analysis., Results: Mcm-2 was identified as a more sensitive and prognostic marker compared to Ki-67 across the study groups. Mcm-2 overexpression was observed in all cases of verrucous hyperplasia with dysplasia, verrucous carcinoma (VC), VSCC, and conventional OSCC. The 3-year OS and DFS rates were lower in conventional OSCC (75 % and 64.3 %, respectively) compared to VSCC (90 % and 70 %)., Conclusion: This study represents the first initiative to employ both Mcm-2 and Ki-67 as proliferative markers for distinguishing between various oral verrucous lesions. Mcm-2 proves to be a valuable marker for differentiating between potentially malignant and malignant verrucous lesions. However, further validation with larger sample sizes and longer follow-up periods is necessary to confirm its role in predicting OS and DFS., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2024. Published by Elsevier Masson SAS.)

Various clinical forms of cutaneous leishmaniasis can be encountered such as: ulcerated, lupoïd, sporotrichoïd and other rare forms (eczematiform, erysipeloid, psoriasiform, verrucous, and pseudotumoral). We report an atypical presentation of verrucous and pseudotumoral cutaneous leishmaniasis that resolved following a course of cryotherapy. [ABSTRACT FROM AUTHOR]

Carcinoma cuniculatum is a rare, slow growing tumour which is commonly mistaken for warts or corn especially when it presents on the sole. Although it rarely metastasizes, it may cause local invasion affecting the underlying tissue and bone. Early identification provides good prognosis as it can be managed with localized resection. We present a case of carcinoma cuniculatum which was misdiagnosed and treated as a common wart for two years until the diagnosis was confirmed by histopathology. By the time of diagnosis, the lesion had involved the underlying bone and patient required amputation. Carcinoma cuniculatum is rare and easily confused with common warts in the early stages hence, it is important to create awareness to identify and differentiate these two conditions. [ABSTRACT FROM AUTHOR]

One to ten percent of all squamous carcinomas are invasive squamous cell carcinomas (ISCC), a rare variation of the disease. According to a recent literature review, less than 25 cases have been reported in the foot and ankle, making it especially uncommon in those areas., Case Presentation: The authors present the case of a male patient, 60 years old, who presented with a progressive mass on his left ankle for 2 years with a history of healed burns in that area. The ISCC was diagnosed using histopathology after which he underwent a marginal excision biopsy and split-thickness skin grafting. Wide-marginal excision and split-thickness skin grafting were done. It was noted that the graft had taken well and that there were clear tumour margins postoperatively. The skin graft was almost completely incorporated. No tumour cells were reported on the margins during the postoperative histopathology., Clinical Discussion: This case highlights a successful outcome of the patient improved at the 12-month follow-up, and he expressed a high degree of satisfaction with the treatment., Conclusion: ISCC of the lower extremities is a rare disease that almost never affects the ankle and is frequently treated inappropriately since it mimics chronic wounds. It is important to have an index of suspicion in patients with a history of chronic irritation to the area of interest. Surgery is the primary option if ICCS is detected. Clear tumour margins are important, and, if done well, excision should be curative., Competing Interests: None., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Verrucous vulvar carcinoma (VC) is an uncommon and distinct histologic subtype of squamous cell carcinoma (SCC). The available literature on VC is currently limited to case reports and small single institution studies., Aims: The goals of this study were to analyze data from the National Cancer Database (NCDB) to quantitate the incidence of VC and to investigate the effects of patient demographics, tumor characteristics, and treatment regimens on overall survival (OS) in women with verrucous vulvar carcinoma., Methods and Results: Patients diagnosed with vulvar SCC or VC between the years of 2004 and 2016 were identified in the NCDB. OS was assessed with Kaplan-Meier curves and the log-rank test. Construction of a Cox model compared survival after controlling for confounding variables. The reported incidence of SCC of the vulva has significantly increased since 2004 (p < .0001). In contrast, the incidence of VC has remained stable (p = .344) since 2004. Compared to SCC, VC was significantly more likely to be diagnosed in older women (p < .0001) and treated with surgery alone (p < .0001). However, on propensity score weighted analysis there was a trend toward improved 5-year OS in women with VC compared to those with SCC (63.4% vs. 57.7%, p = .0794). Multivariable Cox survival analysis showed an improvement in OS in VC patients treated with both primary site and regional lymph node surgery compared to primary site surgery alone (adjusted hazard ratio [aHR] 0.67, 95% confidence interval [CI] 0.46-0.97, p = .0357)., Conclusion: Verrucous carcinoma is more likely to present in older women. Regional lymph node surgery in addition to primary site surgery significantly improves OS in VC patients., (© 2022 The Authors. Cancer Reports published by Wiley Periodicals LLC.)