Warty Dyskeratoma: Diagnosis and Management of a Benign Skin Lesion
A 34-year-old female presented with a discrete cystic lesion on the left labia majora detected during her annual pap test. The lesion was asymptomatic and measured approximately 0.3 cm. A biopsy resulted in a diagnosis of warty dyskeratoma— a benign papulo-nodular lesion associated with squamous epithelium and prominent acantholytic dyskeratosis. Warty dyskeratoma is typically pink or brown, varying from 1 to 10 mm, and often connected to folliculosebaceous units. Its etiology remains unknown, and it is unrelated to HPV.
Warty Dyskeratoma: Diagnosis and Management of a Benign Skin Lesion
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Presentation 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 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
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)
