Necessity of Distinguishing Verrucous Carcinoma From Verrucous Skin Lesion Overlaying Residual Skin Staples in an Area of Sensory Loss: A Case Report

Objective: Verrucous skin lesions on the feet in diabetic neuropathy is a condition usually induced by chronic mechanical stimulation of the feet of patients with diabetic neuropathy and usually occurs at weight-bearing sites. We here present a rare case involving a man with verrucous skin lesions on the feet in diabetic neuropathy at an unusual, non–weight-bearing site. Methods: A 58-year-old man with diabetic neuropathy presented with a verrucous skin lesion overlaying residual skin staples and an amputation stump of the second metatarsal bone on the dorsal foot. Results: The biopsy findings were inconclusive and suggested the necessity of distinguishing the lesion from verrucous carcinoma. The lesion was resected, and the residual skin staples were simultaneously removed. Investigation of the excisional biopsy confirmed our diagnosis of verrucous skin lesions on the feet in diabetic neuropathy. Conclusions: Verrucous skin lesions on the feet in diabetic neuropathy is often difficult to distinguish from verrucous carcinoma; in this case, the unusual location of the lesion could be attributed not only to sensory loss but also to the presence of an amputation stump and the persistence of the residual skin staples.