Verruciform Xanthoma: A Case Report with Immunohistochemical Finding

Abstract

Verruciform xanthoma is a rare clinicopathologic entity which occurs primarily in the oral mucosa. It is difficult to make a diagnosis of verruciform xanthoma based on the clinical findings alone. But the microscopic findings of the characteristic foam cells in the papillary portion of the connective tissue aids in its definitive diagnosis. The origin of the foam cells were thought to be epithelial/dermal dendritic cells (langerhans cells)/neural. But with the advent of immunohistochemistry, it has been established that the foam cells are of monocyte-macrophage lineage because of the strong positivity of these cells to CD-68 antibody. Although no specific etiologic agent or the exact mechanism of its etiopathogenesis is known, a local inflammation or trauma to various triggering factors along non-specific pathways has been suggested. Verruciform xanthoma is known to occur along with other epithelial lesions such as lichen planus, pemphigus etc, but no case has been reported to occur in the same area as the pre-existing site of oral submucous fibrosis in the same patient. This article presents a case of verruciform xanthoma on the left buccal mucosa of a male patient who had history of oral submucous fibrosis in the same area, along with the immunohistochemical findings.