Xantoma verruciforme: características histopatológicas y patogénesis, análisis de casos de vulva y región perianal
Palabras clave:
xantomatosis, células espumosas, necrosis, lípidos, etiologíaResumen
El xantoma verruciforme es una lesión inflamatoria, reactiva, no tumoral, que afecta principalmente la mucosa oral, las semimucosas y la piel de las extremidades. Clínicamente se presenta como lesión única, elevada, de superficie irregular o verrucosa. La histopatología se caracteriza por hiperplasia epidérmica, paraqueratosis extensa con exocitosis de neutrófilos y acúmulos de histiocitos xantomatosos en la dermis papilar. Las hipótesis propuestas para explicar la patogénesis de la enfermedad incluyen origen metabólico, infeccioso, irritantes locales, inflamación crónica y trauma. Las diferentes teorías indican que el evento inicial es el daño de los queratocitos con liberación de productos que inducen respuesta inflamatoria, proliferación celular y liberación de lípidos, que originarían los macrófagos espumosos. El diagnóstico diferencial debe hacerse con condiloma acuminado, carcinoma escamocelular y con el tumor de células granulares. Revisamos la patogénesis del xantoma verruciforme y presentamos dos casos de lesiones en el área perineal, que ilustran sus características histopatológicas.
Biografía del autor/a
Viviana Leticia Arias
Profesora asistente de Patología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
Gerzaín Rodríguez
Catedrático, Facultad de Medicina, Universidad de La Sabana, Chía, Cundinamarca; profesor titular y Maestro universitario, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
Referencias bibliográficas
1. Shafer WG. Verruciform xanthoma. Oral Surg. 1971;31:784-9.
2. Nowparast B, Howell FV, Rick GM. Verruciform xanthoma. A clinicopathologic review and report or fifty-four cases. Oral Surg. 1981;51:619-25.
3. Yu CH, Tsai TC, Wang JT, Liu BY, Wang YP, Sun A, et al. Oral verruciform xanthoma: a clinicopathologic study of 15 cases. J Formos Med Assoc. 2007;106:141-7.
4. Weedon D, editor. Cutaneous infiltrates non lymphoid. In: Skin pathology. London: Churchill Livingstone; 2002. p. 1077-8.
5. Mouncastle EA, Lupton GP. Verruciform xanthomas of the digits. J Am Acad Dermatol. 1989;20:313-7.
6. Chyu J, Medenica M, Whitney DH. Verruciform xanthoma of the lower extremity: Report of a case and review of literature. J Am Acad Dermatol. 1997;17:695-7.
7. Neville B. The verruciform xanthoma. A review and report of eight new cases. Am J Dermatopathol. 1986;8:247-53.
8. Philipsen HP, Reichart PA, Takata T, Ogawa I. Verruciform xanthoma-biological profile of 282 oral lesions based on a literature survey with nine new cases from Japan. Oral Oncol. 2003;39:325-36.
9. Hu JA, Li Y, Li S. Verruciform xanthoma of the oral cavity: Clinicopathological study relating to pathogenesis. Report of three cases. APMIS. 2005;113:629-34.
10. Connolly SB, Lewis EJ, Lindholm JS, Zelickson BD, Zachary CB, Tope WD. Management of cutaneous verruciform xanthoma. J Am Acad Dermatol. 2000;42:343-7.
11. Li H, Lambert WC. Verruciform xanthoma. eMedicine Fecha de acceso: 2 de octubre de 2009. Disponible en: http://www. emedicine.com/derm/topic852.htm.
12. Miller AS, Elzay RP. Verruciform xanthoma of the gingiva: report of six cases. J Periodontol. 1973;44:103-5.
13. Hume WJ, Smith CJ, Franklin CD. Verruciform xanthoma. Br J Oral Surg. 1980;18:157-61.
14. Travis WD, Davis GE, Tsokos M, Lebovics R, Merrick H, Miller S, et al. Multifocal verruciform xanthoma of the upper aerodigestive tract in a child with a systemic lipid storage disease. Am J Surg Pathol. 1989;13:309-16.
15. Pobet E, McCaden ME, Santa Cruz D. Cystic verruciform xanthoma. J Am Acad Dermatol. 1991;25:330-1.
16. Ersahin C, Szpaderska AM, Foreman K, Yong S. Verucciform xanthoma of the penis not associated with human papillomavirus infection. Arch Pathol Lab Med. 2005;129:e62-4. 17. Mannes KD, Deckle CL, Requena L, Sangueza OP. Verruciform xanthoma associated with squamous cell carcinoma. Am J Dermatopathol. 1999;21:66-9. 18. Hu JA, Li YN, Li SY, Ying H. Study of the clinicopathology of verruciform xanthoma of the oral cavity. Shangai J Stomatol. 2005;14:370-3. 19. Jensen JL, Shu –Yuan L, Jeffes III EWB. Verruciform xanthoma of the ear with coexisting epidermal dysplasia. Am J Dermathopatol. 1992;14:426-30.
20. Khaskhely NM, Uezato H, Kamiyama Y, Maruno M, Kariya K, Oshiro M et al. Association of Human Papillomavirus type 6 with a verruciform xanthoma. Am J Dermatopathol. 2000;22:447-52.
21. Barr RJ, Plank CJ. Verruciform xanthoma of the skin. J Cutan Pathol. 1980;7:422-8.
22. Meyers DC, Woosley JT, Reddick RL. Verruciform xanthoma in association with discoid lupus erythematosus. J Cutan Pathol. 1992;19:156-8.
23. Cooper TW, Santa Cruz DJ, Bauer EA. Verruciform xanthoma. Ocurrence in eroded skin in a patient with recessive dystrophic epidermolysis bullosa. J Am Acad Dermatol. 1983; 8:463-7.
24. Murat-Sušic S, Paštar Z, Dobric I, Camino A, Hutinec Z, Husar K, et al. Verruciform xanthoma in recessive dystrophic epidermolysis bullosa Hallopeau-Siemens. Int J Dermatol. 2007;46:955-9.
25. Gehrig RD, Baughman RA, Collins JF. Verruciform xanthoma in a young male patient with a past history of pemphigus vulgaris. Oral Surg. 1983;55:58-61.
26. Snider RL. Verruciform xanthoma and lymphedema. J Am Acad Dermatol. 1992;27:1021-3.
27. Ide F, Obara K, Yamada H, Mishima K, Saito I, Kusama K. Cellular basis of verruciform xanthoma: immunohistochemical and ultrastructural characterization. Oral Dis. 2008;14:150-7.
28. Balus S, Breathnach AS, O´Grady AJ. Ultraestructural observations on foams cells and the source of their lipid in verruciform xanthoma. J Am Acad Dermatol. 1991;24:760-4.
29. Moshin SK, Lee MW, Amin MB, Stoler MH, Eyzaguirre E, Ma CK, et al. Cutaneous verruciform xanthoma: a report of five cases investigating the etiology and nature of xanthomatous cells. Am J Surg Pathol. 1998;22:479-87.
30. Sibaud V, Marit G, Deminiere C, Campana F, Taieb A, Fricain JC. Multiple verruciform xanthomas of the oral mucosa associated with graft versus host disease. Ann Dermatol Venereol. 2006;133:995-9.
31. Smith KJ, Skelton H, Angritt P. Changes of verruciform xanthoma in an HIV –1+ patient with diffuse psoriasiform skin disease. Am J Dermatopathol. 1995;17:185-8.
32. Rawal SY, Kalmar JR, Tatakis DN. Verruciform xanthoma: immunohistochemical characterization of xanthoma cell phenotypes. J Periodontol. 2007;78:504-9.
33. Takiwaki H, Yokota M, Ahsan K, Yokota K, Kurokawa Y, Ogawa I. Squamous cell carcinoma associated with verruciform xanthoma of the penis. Am J Dermatopathol. 1996;18:551-3.
34. Sharma D, Pradeep AR. Xanthomatous changes in a case provisionally diagnosed as fibroma: a case report. NY State Dent J. 2007;73:61-3.
35. Baloch ZW, Martin S, LiVolsi VA. Granular cell tumor of the thyroid: a case report. Int Jurnal Surg Pathol. 2005;13:291-4.
36. McKee PH, Calonje E, Granter SR, editores. Connective tissue tumors. In: Pathology of the skin with clinical correlations. Third edition. Philadelphia: Elsevier Mosby; 2005. p. 1779-1781
37. Duray PH, Johnston Y. Verruciform xanthoma of the nose in an elderly male. Am J Dermatopathol. 1986;8:237-40.
2. Nowparast B, Howell FV, Rick GM. Verruciform xanthoma. A clinicopathologic review and report or fifty-four cases. Oral Surg. 1981;51:619-25.
3. Yu CH, Tsai TC, Wang JT, Liu BY, Wang YP, Sun A, et al. Oral verruciform xanthoma: a clinicopathologic study of 15 cases. J Formos Med Assoc. 2007;106:141-7.
4. Weedon D, editor. Cutaneous infiltrates non lymphoid. In: Skin pathology. London: Churchill Livingstone; 2002. p. 1077-8.
5. Mouncastle EA, Lupton GP. Verruciform xanthomas of the digits. J Am Acad Dermatol. 1989;20:313-7.
6. Chyu J, Medenica M, Whitney DH. Verruciform xanthoma of the lower extremity: Report of a case and review of literature. J Am Acad Dermatol. 1997;17:695-7.
7. Neville B. The verruciform xanthoma. A review and report of eight new cases. Am J Dermatopathol. 1986;8:247-53.
8. Philipsen HP, Reichart PA, Takata T, Ogawa I. Verruciform xanthoma-biological profile of 282 oral lesions based on a literature survey with nine new cases from Japan. Oral Oncol. 2003;39:325-36.
9. Hu JA, Li Y, Li S. Verruciform xanthoma of the oral cavity: Clinicopathological study relating to pathogenesis. Report of three cases. APMIS. 2005;113:629-34.
10. Connolly SB, Lewis EJ, Lindholm JS, Zelickson BD, Zachary CB, Tope WD. Management of cutaneous verruciform xanthoma. J Am Acad Dermatol. 2000;42:343-7.
11. Li H, Lambert WC. Verruciform xanthoma. eMedicine Fecha de acceso: 2 de octubre de 2009. Disponible en: http://www. emedicine.com/derm/topic852.htm.
12. Miller AS, Elzay RP. Verruciform xanthoma of the gingiva: report of six cases. J Periodontol. 1973;44:103-5.
13. Hume WJ, Smith CJ, Franklin CD. Verruciform xanthoma. Br J Oral Surg. 1980;18:157-61.
14. Travis WD, Davis GE, Tsokos M, Lebovics R, Merrick H, Miller S, et al. Multifocal verruciform xanthoma of the upper aerodigestive tract in a child with a systemic lipid storage disease. Am J Surg Pathol. 1989;13:309-16.
15. Pobet E, McCaden ME, Santa Cruz D. Cystic verruciform xanthoma. J Am Acad Dermatol. 1991;25:330-1.
16. Ersahin C, Szpaderska AM, Foreman K, Yong S. Verucciform xanthoma of the penis not associated with human papillomavirus infection. Arch Pathol Lab Med. 2005;129:e62-4. 17. Mannes KD, Deckle CL, Requena L, Sangueza OP. Verruciform xanthoma associated with squamous cell carcinoma. Am J Dermatopathol. 1999;21:66-9. 18. Hu JA, Li YN, Li SY, Ying H. Study of the clinicopathology of verruciform xanthoma of the oral cavity. Shangai J Stomatol. 2005;14:370-3. 19. Jensen JL, Shu –Yuan L, Jeffes III EWB. Verruciform xanthoma of the ear with coexisting epidermal dysplasia. Am J Dermathopatol. 1992;14:426-30.
20. Khaskhely NM, Uezato H, Kamiyama Y, Maruno M, Kariya K, Oshiro M et al. Association of Human Papillomavirus type 6 with a verruciform xanthoma. Am J Dermatopathol. 2000;22:447-52.
21. Barr RJ, Plank CJ. Verruciform xanthoma of the skin. J Cutan Pathol. 1980;7:422-8.
22. Meyers DC, Woosley JT, Reddick RL. Verruciform xanthoma in association with discoid lupus erythematosus. J Cutan Pathol. 1992;19:156-8.
23. Cooper TW, Santa Cruz DJ, Bauer EA. Verruciform xanthoma. Ocurrence in eroded skin in a patient with recessive dystrophic epidermolysis bullosa. J Am Acad Dermatol. 1983; 8:463-7.
24. Murat-Sušic S, Paštar Z, Dobric I, Camino A, Hutinec Z, Husar K, et al. Verruciform xanthoma in recessive dystrophic epidermolysis bullosa Hallopeau-Siemens. Int J Dermatol. 2007;46:955-9.
25. Gehrig RD, Baughman RA, Collins JF. Verruciform xanthoma in a young male patient with a past history of pemphigus vulgaris. Oral Surg. 1983;55:58-61.
26. Snider RL. Verruciform xanthoma and lymphedema. J Am Acad Dermatol. 1992;27:1021-3.
27. Ide F, Obara K, Yamada H, Mishima K, Saito I, Kusama K. Cellular basis of verruciform xanthoma: immunohistochemical and ultrastructural characterization. Oral Dis. 2008;14:150-7.
28. Balus S, Breathnach AS, O´Grady AJ. Ultraestructural observations on foams cells and the source of their lipid in verruciform xanthoma. J Am Acad Dermatol. 1991;24:760-4.
29. Moshin SK, Lee MW, Amin MB, Stoler MH, Eyzaguirre E, Ma CK, et al. Cutaneous verruciform xanthoma: a report of five cases investigating the etiology and nature of xanthomatous cells. Am J Surg Pathol. 1998;22:479-87.
30. Sibaud V, Marit G, Deminiere C, Campana F, Taieb A, Fricain JC. Multiple verruciform xanthomas of the oral mucosa associated with graft versus host disease. Ann Dermatol Venereol. 2006;133:995-9.
31. Smith KJ, Skelton H, Angritt P. Changes of verruciform xanthoma in an HIV –1+ patient with diffuse psoriasiform skin disease. Am J Dermatopathol. 1995;17:185-8.
32. Rawal SY, Kalmar JR, Tatakis DN. Verruciform xanthoma: immunohistochemical characterization of xanthoma cell phenotypes. J Periodontol. 2007;78:504-9.
33. Takiwaki H, Yokota M, Ahsan K, Yokota K, Kurokawa Y, Ogawa I. Squamous cell carcinoma associated with verruciform xanthoma of the penis. Am J Dermatopathol. 1996;18:551-3.
34. Sharma D, Pradeep AR. Xanthomatous changes in a case provisionally diagnosed as fibroma: a case report. NY State Dent J. 2007;73:61-3.
35. Baloch ZW, Martin S, LiVolsi VA. Granular cell tumor of the thyroid: a case report. Int Jurnal Surg Pathol. 2005;13:291-4.
36. McKee PH, Calonje E, Granter SR, editores. Connective tissue tumors. In: Pathology of the skin with clinical correlations. Third edition. Philadelphia: Elsevier Mosby; 2005. p. 1779-1781
37. Duray PH, Johnston Y. Verruciform xanthoma of the nose in an elderly male. Am J Dermatopathol. 1986;8:237-40.
Cómo citar
1.
Arias VL, Rodríguez G. Xantoma verruciforme: características histopatológicas y patogénesis, análisis de casos de vulva y región perianal. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 26 de febrero de 2019 [citado 20 de abril de 2024];18(3):160-5. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/327
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2019-02-26
Cómo citar
1.
Arias VL, Rodríguez G. Xantoma verruciforme: características histopatológicas y patogénesis, análisis de casos de vulva y región perianal. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 26 de febrero de 2019 [citado 20 de abril de 2024];18(3):160-5. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/327
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