UPMC Dermatopathology "Case of the Month" Presentations
UPP - Department of Dermatology, Dermatopathology Unit
Justin Haught, MD; Drazen Jukic, MD/PhD; Joseph English III, MD
DECEMBER 2007 CASE OF THE MONTH
CLINICAL FINDINGS
A 38 year-old white male presented with a 25-year history of multiple “warts” over his distal upper and lower extremities, inculding the dorsal hands and feet. He stated that the lesions are asymptomatic and he often “pulls them off”. Some moisturizers he had tried in the past help to soften the lesions, although nothing completely resolved them. He had no significant past medical history or chronic medical diseases. On further history, he stated that his father has similar lesions with a similar course.
Physical exam revealed hundreds to thousands of 1-3mm gray-white verrucous papules with a “stuck-on” appearance over the patient’s hands, feet, and distal upper and lower extremities. (Fig. 1 and 2) His head, neck, trunk, and groin were within normal limits.
Biopsy revealed a verrucous lesion on low power with hyperkeratosis, acanthosis, and papillomatosis in a “church-spire” configuration. (Fig. 3 and 4)
None obtained.
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