ABSTRACT
Epidermoid cysts with histopathologic features of human papillomavirus (HPV) infection have been previously reported and are commonly termed verrucous cysts. We report a series of eight histopathologically distinct verrucous pilar cysts, distinguished from traditional verrucous epidermoid cysts by trichilemmal keratinization, as well as two verrucous hybrid pilar-epidermoid cysts. These lesions contain characteristic stratified epithelial linings with abrupt transitions to compact eosinophilic keratin, as well as areas of papillomatosis, coarse intracytoplasmic keratohyalin granules, and vacuolar structures suggestive of HPV-induced cytopathic change. HPV-24, a ß genus HPV species, was identified by degenerate polymerase chain reaction in DNA extracted from two of the lesions, and the presence of ß-HPV E4 protein was confirmed by immunohistochemistry. HPV-60, the HPV species most commonly reported in verrucous epidermoid cysts, was not detected. Verrucous pilar cysts represent histopathologically and potentially etiologically distinct lesions which may be underrecognized.
Subject(s)
Epidermal Cyst , Papillomaviridae/metabolism , Papillomavirus Infections , Skin Diseases, Viral , Adult , Aged , Epidermal Cyst/metabolism , Epidermal Cyst/pathology , Epidermal Cyst/virology , Female , Humans , Male , Middle Aged , Oncogene Proteins, Viral/metabolism , Papillomavirus Infections/metabolism , Papillomavirus Infections/pathology , Papillomavirus Infections/virology , Skin Diseases, Viral/metabolism , Skin Diseases, Viral/pathology , Skin Diseases, Viral/virologySubject(s)
Epidermal Cyst , Skin Diseases , Aged , Epidermal Cyst/metabolism , Epidermal Cyst/pathology , Humans , Male , Skin Diseases/metabolism , Skin Diseases/pathologyABSTRACT
Verrucous cyst is a rare form of epidermal cyst showing verrucous changes of their stratified squamous epithelial lining, characterized by papillomatosis, acanthosis, and hypergranulosis with large, irregular keratohyaline granules. In addition, vacuolated keratinocytes, parakeratosis, and squamous eddies are often present. Herein, we describe a 45-year-old woman with a verrucous cyst, which occurred on left axilla three months ago, showing the above-mentioned characteristic histologic features. Both the immunohistochemical stain and polymerase chain reaction for the common antigen for human papillomavirus and DNA chip study for the human papillomavirus were negative.
