Warty dyskeratoma

	WikiDoc Resources for Warty dyskeratoma
Articles
Most recent articles on Warty dyskeratoma Most cited articles on Warty dyskeratoma Review articles on Warty dyskeratoma Articles on Warty dyskeratoma in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Warty dyskeratoma Images of Warty dyskeratoma Photos of Warty dyskeratoma Podcasts & MP3s on Warty dyskeratoma Videos on Warty dyskeratoma
Evidence Based Medicine
Cochrane Collaboration on Warty dyskeratoma Bandolier on Warty dyskeratoma TRIP on Warty dyskeratoma
Clinical Trials
Ongoing Trials on Warty dyskeratoma at Clinical Trials.gov Trial results on Warty dyskeratoma Clinical Trials on Warty dyskeratoma at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Warty dyskeratoma NICE Guidance on Warty dyskeratoma NHS PRODIGY Guidance FDA on Warty dyskeratoma CDC on Warty dyskeratoma
Books
Books on Warty dyskeratoma
News
Warty dyskeratoma in the news Be alerted to news on Warty dyskeratoma News trends on Warty dyskeratoma
Commentary
Blogs on Warty dyskeratoma
Definitions
Definitions of Warty dyskeratoma
Patient Resources / Community
Patient resources on Warty dyskeratoma Discussion groups on Warty dyskeratoma Patient Handouts on Warty dyskeratoma Directions to Hospitals Treating Warty dyskeratoma Risk calculators and risk factors for Warty dyskeratoma
Healthcare Provider Resources
Symptoms of Warty dyskeratoma Causes & Risk Factors for Warty dyskeratoma Diagnostic studies for Warty dyskeratoma Treatment of Warty dyskeratoma
Continuing Medical Education (CME)
CME Programs on Warty dyskeratoma
International
Warty dyskeratoma en Espanol Warty dyskeratoma en Francais
Business
Warty dyskeratoma in the Marketplace Patents on Warty dyskeratoma
Experimental / Informatics
List of terms related to Warty dyskeratoma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2] Kiran Singh, M.D. [3]

Synonyms and keywords: Isolated dyskeratosis follicularis

Overview

Warty dyskeratoma (WD) is a benign epidermal proliferation^[1] with distinctive histological findings that may mimic invasive squamous cell carcinoma^[2] and commonly manifests as an umbilicated (having a central mark or depression resembling a navel) lesion with a keratotic plug.^[3]

Historical Perspective

Warty dyskeratoma was first described by Graham and Helwig as isolated Darier’s disease in 1954. The name warty dyskeratoma was first coined by Szymanski in 1957 after his review of the cases.

Causes

The etiology of warty dyskeratoma is unclear, but a viral infection, smoking, autoimmunity, and ultraviolet light have been postulated to play a role. Several hypothesis reveal histopathologic similarities to viral warts but it's not caused by HPV and the majority of these lesions display overall histopathologic features consistent with a follicular adnexal neoplasm.^[4]

Differentiating Warty Dyskeratoma from other Conditions

Warty dyskeratoma can also be thought of as one of the manifestations of focal acantholytic dyskeratosis, an epidermal reaction pattern that can be seen in several disorders, including Darier's disease and Grover's disease.^[5] But the main difference between Darier disease and warty dyskeratoma, is that Darier's disease inherited dermatosis (autosomal dominant) consisting of multiple keratotic papules on the face, trunk, and extremities, while WD occurs as an isolated, noninherited, single keratotic nodule mainly confined to the head and neck as mentioned earlier.^[6]
Warty dyskeratoma must be differentiated from viral-induced squamous lesions.

Differential Diagnosis

Epidemiology and Demographics

Warty dyskeratoma is a rare epidermal tumor that frequently arises as a papule or nodule on the head or neck of middle-aged or older persons.

Diagnosis

History and Symptoms

The patient usally comes complaing of pruritus that is usually limited to the head, neck,^[6] scalp^[7] or face and vulva.^[6]
Lesions are generally solitary and sporadic and may be associated with a follicular unit.
Oral involvement, particularly the hard palate, and genital involvement have been reported. They may also complain of recurrent foul-smelling cheesy drainage from the lesions.^[3]
There may be central bleeding associated with trauma to the lesion.

Laboratory Findings

Hisotopathological examination of the lesions may reveal a cup-shaped invagination filled with a keratotic plug.
The invagination contains numerous acantholytic dyskeratotic cells and typical corps ronds can be seen at the entrance to the invagination.
The lower portion of the invagination may show the presence of many villi that are often covered by a single layer of basaloid cells and these villi protrude upward.

HPE of warty dyskeratoma showing keratotic plug

Physical Examination

Skin

Trunk

Warty dyskeratoma. Adapted from Dermatology Atlas.^[8]
Warty dyskeratoma. Adapted from Dermatology Atlas.^[8]
Warty dyskeratoma. Adapted from Dermatology Atlas.^[8]
Warty dyskeratoma. Adapted from Dermatology Atlas.^[8]

Treatment

The treatment of choice of WD is surgical excision.
Other possible modalities of treatment are available but they are frequently associated with recurrences. These modalities include:
- Curettement with electro-desiccation
- Irradiation with X-ray ^[9]
- Tazarotenic acid gel ^[10]

References

↑ Diallo M, Cribier B, Scrivener Y (2007). "[Warty dyskeratoma: infundibular histogenesis. Anatomoclinical study of 43 cases]". Ann Dermatol Venereol (in French). 134 (8–9): 633–6. PMID 17925685.
↑ Chau MN, Radden BG (1984). "Oral warty dyskeratoma". J. Oral Pathol. 13 (5): 546–56. doi:10.1111/j.1600-0714.1984.tb01455.x. PMID 6434720. Unknown parameter |month= ignored (help)
↑ ^3.0 ^3.1 Kaugars GE, Lieb RJ, Abbey LM (1984). "Focal oral warty dyskeratoma". Int. J. Dermatol. 23 (2): 123–30. doi:10.1111/j.1365-4362.1984.tb05686.x. PMID 6698687. Unknown parameter |month= ignored (help)
↑ Kaddu S, Dong H, Mayer G, Kerl H, Cerroni L (2002). "Warty dyskeratoma--"follicular dyskeratoma": analysis of clinicopathologic features of a distinctive follicular adnexal neoplasm". J. Am. Acad. Dermatol. 47 (3): 423–8. doi:10.1067/mjd.2002.122756. PMID 12196754. Unknown parameter |month= ignored (help)
↑ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
↑ ^6.0 ^6.1 ^6.2 ^6.3 Duray PH, Merino MJ, Axiotis C (1983). "Warty dyskeratoma of the vulva". Int. J. Gynecol. Pathol. 2 (3): 286–93. doi:10.1097/00004347-198303000-00006. PMID 6642851.
↑ Griffiths TW, Hashimoto K, Sharata HH, Ellis CN (1997). "Multiple warty dyskeratomas of the scalp". Clin. Exp. Dermatol. 22 (4): 189–91. doi:10.1111/j.1365-2230.1997.tb01059.x. PMID 9499610. Unknown parameter |month= ignored (help)
↑ ^8.0 ^8.1 ^8.2 ^8.3 "Dermatology Atlas".
↑ Tanay A, Mehregan AH (1969). "Warty dyskeratoma". Dermatologica. 138 (3): 155–64. PMID 5773508.
↑ Abramovits W, Abdelmalek N (2002). "Treatment of warty dyskeratoma with tazarotenic acid". J Am Acad Dermatol. 46 (2 Suppl Case Reports): S4. PMID 11807455.

Template:WikiDoc Sources

[pmid-1] Diallo M, Cribier B, Scrivener Y (2007). "[Warty dyskeratoma: infundibular histogenesis. Anatomoclinical study of 43 cases]". Ann Dermatol Venereol (in French). 134 (8–9): 633–6. PMID 17925685.

[pmid6434720-2] Chau MN, Radden BG (1984). "Oral warty dyskeratoma". J. Oral Pathol. 13 (5): 546–56. doi:10.1111/j.1600-0714.1984.tb01455.x. PMID 6434720. Unknown parameter |month= ignored (help)

[pmid6698687-3] 3.0 ^3.1 Kaugars GE, Lieb RJ, Abbey LM (1984). "Focal oral warty dyskeratoma". Int. J. Dermatol. 23 (2): 123–30. doi:10.1111/j.1365-4362.1984.tb05686.x. PMID 6698687. Unknown parameter |month= ignored (help)

[pmid12196754-4] Kaddu S, Dong H, Mayer G, Kerl H, Cerroni L (2002). "Warty dyskeratoma--"follicular dyskeratoma": analysis of clinicopathologic features of a distinctive follicular adnexal neoplasm". J. Am. Acad. Dermatol. 47 (3): 423–8. doi:10.1067/mjd.2002.122756. PMID 12196754. Unknown parameter |month= ignored (help)

[Andrews-5] James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.

[pmid6642851-6] 6.0 ^6.1 ^6.2 ^6.3 Duray PH, Merino MJ, Axiotis C (1983). "Warty dyskeratoma of the vulva". Int. J. Gynecol. Pathol. 2 (3): 286–93. doi:10.1097/00004347-198303000-00006. PMID 6642851.

[pmid9499610-7] Griffiths TW, Hashimoto K, Sharata HH, Ellis CN (1997). "Multiple warty dyskeratomas of the scalp". Clin. Exp. Dermatol. 22 (4): 189–91. doi:10.1111/j.1365-2230.1997.tb01059.x. PMID 9499610. Unknown parameter |month= ignored (help)

[Dermatology_Atlas-8] 8.0 ^8.1 ^8.2 ^8.3 "Dermatology Atlas".

[pmid5773508-9] Tanay A, Mehregan AH (1969). "Warty dyskeratoma". Dermatologica. 138 (3): 155–64. PMID 5773508.

[pmid11807455-10] Abramovits W, Abdelmalek N (2002). "Treatment of warty dyskeratoma with tazarotenic acid". J Am Acad Dermatol. 46 (2 Suppl Case Reports): S4. PMID 11807455.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]