Verruciform xanthoma

The twenty-sixth case of verruciform xanthoma is reported. The clinical and light microscopic findings in this case are similar to those previously described of a shaggy, parakeratin-covered, pebbly, or verrucous surface and elongated rete pegs which extend a uniform depth into the underlying connective tissue. Large “foam cells” or xanthoma cells filled only the connective tissue papillae between the epithelial pegs. The 1.5 by 4 cm. lesion in our patient is the largest verruciform xanthoma reported to date and is the first to be reported in a black person.