Lésion papulo-squameuse chronique: penser au papillome

Papilloma is a benign tumor of the malpighian layer, usualy affecting the skin. Thickened epithelium doesn’t show cytological or architectural abnormalities; the epithelial proliferation is still clearly separated from the dermis by the basal membrane, that is to say absence of tumor infiltration. We here report the case of a 15-year-old boy presenting with oozing plague in his left elbow that had evolved over the previous two months. The patient had no particular previous history. Physical examination showed good general condition and a papular, squamous, itchy, oozing lesion measuring 4 cm along its longer axis. The remainder of the physical examination was normal. He was treated with topical emollient, antimycotics and quinolone antibiotics. Drying of the purulent oozing was observed, but no improvement in the general appearance of the lesion. Laboratory tests, including glucose tolerance test, were normal. A biopsy of the lesion was performed. Anatomo-pathological examination of skin biopsy specimen showed no abnormal cells, rather an elongation of the epidermal ridges as well as of the connective papillae, extensive keratinization of the surface and thickening of the malpighian layer. The diagnosis of papilloma was retained. Surgical excision of the tumor resulted in complete healing.