PMC5271671_01
Clinical and pathologic presentation of VX. A, Soft papillomatous tumor arising within the proximal border of a shallow ulcer on the right anterior tibia. B, Low-power view of the papillomatous (fingerlike) appearance of the mass. C, Foamy histiocytes infiltrating the dermis. D, Brightly eosinophilic parakeratosis dissecting into the dermis. E, Low-power view of p16 staining of the lesion. F, High-power view of p16 staining of the lesion.
gr1.jpg
PMC5271671_01_gr1.jpg
fig1
Physical examination found a 5- by 7-cm oval shallow ulcer on the right anterior shin, with a soft "cauliflowerlike" mass at the upper border of the ulcer (Fig 1, A). Histopathologic analysis found a keratotic verrucous papillomatous lesion on low power (Fig 1, B). On higher power, foamy histiocytes filled the expanded papillary dermis of the lesion (Fig 1, C). Dissecting parakeratosis was also noted on high magnification (Fig 1, D). The tumor expressed p16 protein, compared with the adjacent uninvolved epidermis (Fig 1, E and F).