Warty dyskeratomaL85.8

Szymanski 1957

Rare, mostly solitary (only very occasionally multiple), benign, usually verrucous tumor with histologic signs of acantholytic dyskeratosis.

Face, hairy head. Rare extremities or trunk. Dyskeratomas of the oral mucosa are a special form of dyskeratomas of the oral mucosa, which are located mainly on the hard palate, buccally or on the alveolar ridge.

Mostly isolated (rarely multiple), skin-coloured to darkly pigmented neoplasm presenting as a (clinically uncharacteristic) skin-coloured or reddish, surface-smooth or also centrally keratotic nodule (or plaque). Cases of scaly plaques reminiscent of actinic keratosis have also been reported. A warty dyskeratoma under the clinical picture of a cornu cutaneum has also been described. The warty dyskeratomas of the oral mucosa occupy a special position. The diagnosis is made exclusively as a histological incidental diagnosis.

Moderately exophytic, sharply defined tumour with sunken surface. Irregularly acanthotic epithelial band overlaid by a strong orthokeratotic corneal layer which is crossed by parakeratotic stripes. An irregularly occurring suprabasal acantholysis is conspicuous, here groups of detached epithelia with eosinophilic cytoplasm and condensed nuclei are found. In the upper epithelial layers numerous dyskeratotic elements, dense lympho-histiocytic infiltrate in the dermis.

• Clinical:
  • Seborrheic keratosis
  • Viral papillomas (especially if they occur in the mucous membrane area)
  • Actinic keratosis
• Histological:
  • Keratosis actinica (acantholytic form); here, in addition to acantholysis, a disturbed disordered cell structure and intraepidermal dyskeratoses are found.
  • Pemphigus chronicus benignus familiaris
  • pemphigus vegetans
  • transient acantholytic dermatosis
  • acantholytic dyskeratotic acanthoma: here the intussusception typical for the warty dyskeratoma is missing.
  • Incidental focal acantholytic dyskeratosis: the intussusception typical of the warty dyskeratoma is missing.

1. Allon I et al (2012) Warty dyskeratoma/focal acantholytic dyskeratosis--an update on a rare oral lesion. J Oral Pathol Med 41:261-267
2. Bergua P et al (2003) Congenital acantholytic dyskeratotic dermatosis: localized Darier disease or disseminated benign papular acantholytic dermatosis? Pediatr Dermatol 20:262-265
3. Griffiths TW et al (1997) Multiple warty dyskeratomas of the scalp. Clin Exp Dermatol 22: 189-191
4. Kaddu S et al (2002) Warty dyskeratoma--"follicular dyskeratoma": analysis of clinicopathologic features of a distinctive follicular adnexal neoplasm. J Am Acad Dermatol 47: 423-428.
5. Kargi E (2003) An atypical lesion on the forehead: warty dyskeratoma. Plast Reconstr Surg 111: 1562-1563
6. Lora V et al (2014) Warty dyskeratoma as a cutaneous horn of the
7. Mons Pubis. Am J Dermatopathol 37:802-804
8. Phelps P et al (2015) Warty dyskeratoma of the eyelid. Ophthalmology 122:1282
9. Szymanski FJ (1957) Warty dyskeratoma, a benign cutaneous tumor resembling Darier's disease microscopically. Arch Dermatol 75: 567-572
10. Ugras N et al (2014) Multiple warty dyskeratomas: casereport. Iran J Public Health 43:1145-1147.

11. Zhao Q et al (2019) Multiple warty dyskeratoma on the scalp. An Bras Dermatol 94:630-631.