《Slide 147.》Deep palmoplantar warts, Skin

A. Brief Descriptions：

1. Not only on the palm and soles but also on the lateral aspects and tips of the fingers and toes.

2. Human papilloma virus type I.

3. Tender and occasionally swollen and red.

B. Gross Findings：

1. Soft, granular, white or brownish tissue covered with a thick callus

C. Micro Findings：

1. Endophytic epidermal lesion with a central parakeratotic plug surrounded by multiple deep extension of acanthotic epidermis.

2.  Present of abundant eosinophilic keratohyalin.

3. In the lower epidermis, keratohyalin within the cytoplasm of many cells as eosinophilic granules, which enlarge in the upper stratum malpighii and coalesce to form large, irregular shaped, homogenous “inclusion bodies”.

4. These inclusion bodies either encase the vacuolated nucleus or are separated from it by perinuclear vacuolization, but they do not displace the nucleus laterally.

5. The nucleus in the stratum corneum persist, appearing as deep basophilic round bodies surrounded by a wide, clear zone.

6. Aside from the large intracytoplasmic inclusion bodies, some cells in the upper stratum malpighii with vacuolated nuclei also with small (about the same size of nuclei) intracytoplasmic eosinophilic inclusion body.

D. Others：

1. Also name as “myrmecia”

2. Occur not only on the palms and soles, but also on the lateral aspects and tips of the fingers and toes.

3. Serotype HPV (human papillomavirus) type 1

E. Reference：

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【 Fig. 147-1 (4X)】

　

 

 

【 Fig. 147-2 (4X)】

　

 

 

【 Fig. 147-3 (10X)】

　

 

 

【 Fig. 147-4 (10X)】

　

 

 

【 Fig. 147-5 (20X)】

　

 

 

【 Fig. 147-6 (20X)】

　

 

 

【 Fig. 147-7 (40X)】