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Sporotrichosis is a cutaneous mycosis caused by a dimorphic fungus, Sporothrix schenckii species complex clinically presenting as lymphocutaneous, fixed, or disseminated forms. A typical lesion is an erythematous papule, noduloulcerative lesion usually occurring at the site of penetrating trauma, mostly on the extremities. Verrucous lesion is an unusual presentation of sporotrichosis which can mimic the verrucous lesions seen in chromoblastomycosis, tuberculosis verruca cutis/lupus vulgaris (TBVC/LV), cutaneous leishmaniasis, and blastomycosis leading to diagnostic dilemma. Herein, we describe a case of facial verrucous sporotrichosis in a child from sub-Himalayan region. [ABSTRACT FROM AUTHOR]

Verrucous hemangioma is an uncommon capillary or cavernous hemangioma with reactive epidermal changes of hyperkeratosis, acanthosis, and papillomatosis. Lesions are mostly seen at birth or appear during childhood. These growths are usually located on the lower extremities, and involvement is generally unilateral. Diagnosis of this unusual presentation can only be confirmed following histopathology. Surgical excision resulted in a satisfactory functional and cosmetic outcome. [ABSTRACT FROM AUTHOR]

Lymphangioma circumscriptum (LC) is characterized by dilation of lymphatic vessels in the skin and subcutaneous tissue. It presents as asymptomatic vesicles filled with lymphatic fluid giving characteristic frog spawn appearance, but does not progress into warty plaque. LC can also be divided into congenital and acquired form. The common sites are axillary folds, shoulder, upper arm, scrotum, penis, rectum, and vulva. It needs to be differentiated from certain common conditions such as herpes zoster, molluscum contagiosum, hemangioma, verruca vulgaris, and angiokeratoma. Surgical modality is the first choice of treatment. A case of a 5-year-old girl having verrucous plaque on the right knee joint diagnosed as LC is presented here. [ABSTRACT FROM AUTHOR]

Verrucous hemangioma is an uncommon congenital vascular malformation, which may clinically masquerade angiokeratoma, lymphangioma circumscriptum, or malignant melanoma. Differentiation is essential owing to varied therapeutic and prognostic implications. We present a rare case of multiple verrucous hemangiomas in a teenage girl who presented with multiple warty lesions over the dorsal aspect of the left foot since birth. Magnetic resonance imaging (MRI) scan was suggestive of a vascular malformation, and skin biopsy showed ectatic blood vessels extending from the papillary dermis into the subcutaneous tissue, diagnostic of verrucous hemangioma. A combination of 0.05% halobetasol propionate with 3% salicylic acid ointment was advised. This therapeutic intervention resulted in significant resolution of the warty lesions over a period of 2 months, following which surgical excision was performed. The implication is that we can use a combination of super potent topical steroid with salicylic acid as an adjunct to surgical resection. [ABSTRACT FROM AUTHOR]

Sebaceous hyperplasia (SH), a common, benign condition of sebaceous gland, presents most commonly over face. Lesions are usually described as asymptomatic, soft, discrete, and yellow with a surface that ranges from smooth to slightly verrucous. The pathogenesis is not fully understood. It does not require treatment, but many time lesions can be cosmetically unfavorable than, need to be destroyed or excised. A case of 23-year-old male presenting with the skin colored to hyperpigmented linear hyperkeratotic plaque mimicking a wart, over the right ear is presented here, which was diagnosed as SH. [ABSTRACT FROM AUTHOR]

Linear verrucous hemangioma (VH) is a rare congenital disorder of vascular malformation characterized by the presence of verrucous and vascular plaques or nodules arranged in a linear array. Clinically, the closest differential includes angiokeratoma which can be differentiated based on histopathology. We herein report a case of linear VH in a pediatric age group. [ABSTRACT FROM AUTHOR]

Angiokeratoma circumscriptum neviforme (ACN) is an extremely rare cutaneous disorder, occurring due to congenital malformation of the papillary dermal blood vessels. Clinically, it presents as well circumscribed, hyperkeratotic papules, nodules or plaques, often resembling malignant tumors like malignant melanoma or pigmented basal cell carcinoma. Thus, this uncommon but significant lesion should be diagnosed at the earliest, to avoid unnecessary confusion. We report here a case of congenital, linear, unilateral, verrucous plaques on the leg of a young girl, diagnosed as ACN. [ABSTRACT FROM AUTHOR]

A 68-year-old man, a known case of hypertension, coronary artery disease and old cardiovascular accident with right-sided hemiplegia, came with the chief complaints of a large cauliflower like growth with pus discharge on the left heel since 15 years. The patient had sustained a penetrating injury by a thorn on the left heel region few days before the lesion appeared. Dermatological examination revealed a single verrucous lesion measuring 7 x 7 cm on the left heel region associated with discharge of foul smelling cheesy material. There was also a enlarged right inguinal lymph node which was non-tender, firm, measuring 2 cm in diameter with normal overlying skin. X-ray left ankle was done which showed some soft tissue swelling. A skin biopsy showed hyperkeratosis, acanthosis and parakeratosis. Elongated rete ridges with keratinocyte hyperplasia, forming a large mass pressing on the underlying dermis were seen. There was formation of multiple large keratin filled invaginations and crypts. No atypical cells were seen. Based on history, clinical examination and investigations, a diagnosis of epithelium cuniculatum type of verrucous squamous cell carcinoma was made. A wide excision with a flap cover was performed in consultation with the oncosurgeon and the excision sample was sent for histopathological re-examination, which confirmed the diagnosis of epithelioma cuniculatum. [ABSTRACT FROM AUTHOR]

Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder characterized by capillary malformation, vascular anomalies, and bony and soft tissue hypertrophy. Angiokeratomas are of several types. Angiokeratoma circumscriptum (AC) is a nevoid form which presents as dark red papules and plaques mostly with a verrucous surface. AC is itself very rare. KTS along with AC is even rarer. Here, we present a rare case of KTS with AC on the background of port-wine stain. [ABSTRACT FROM AUTHOR]

Pseudoepitheliomatous, keratotic, and micaceous balanitis is a rare condition characterized by verrucous excrescences with scaling. Most patients are over the age of 50 and frequently have been circumcised for phimosis in adult life. We present here a case of 35-year-old male patient with long standing phimosis presenting with a firm whitish plaque on the glans penis. The crusts were micaceous in nature. Histopathologically, there was pseudoepitheliomatous hyperplasia with acanthosis and no cellular atypia. The condition was explained to the patient and treatment options discussed. The patient was started on topical 5-fluorouracil cream on a daily basis as he did not express consent for operative intervention. [ABSTRACT FROM AUTHOR]

Verrucous lesions of the penis are rare and difficult to classify. Superficial biopsy in any of the verrucous lesions shows only hyperkeratosis, acanthosis, and papillomatosis. Therefore, an adequate biopsy is a must to show the rete pegs that extend into the deeper tissues. Deeper biopsies are always required for an accurate diagnosis. These nonneoplastic lesions of the penis need to be differentiated from cancer which is associated with high morbidity. We report a case of a verrucous lesion of the penis in a 38-year-old male. [ABSTRACT FROM AUTHOR]

Verrucous hemangioma is a rare form of vascular malformation which is usually congenital. Most of the cases present as wart-like dark blue to erythematous papules, nodules and plaques with special predilection in lower extrimities. We are reporting here a 19-year-old Muslim patient with large Verrucous hemangioma in the left leg along with discending of right shoulder without any signs of neurological involvement. Patient was successfully treated with repeat serial Electrocautory. [ABSTRACT FROM AUTHOR]