Histopathological Study of Verrucous Lesions and its Mimics

CONTEXT: Verrucous lesions pose a diagnostic challenge to the clinicians as well as pathologists. There are few discrete histological features which if looked for carefully can help differentiate them. AIM: The aim of this study is to bring into light the histological features of several verrucous lesions occuring on skin and mucosa lined by squamous epithelium. SETTINGS AND DESIGN: This is a 6-month prospective and retrospective study done on cutaneous and squamous mucosal biopsies with an exophytic pattern of growth. Clinical details along with the diagnosis were retrieved from the case files and correlated with the histological diagnosis. SUBJECTS AND METHODS: Only hematoxylin and eosin-stained sections were studied. RESULTS: Of the 35 cases, 10 (28.5%) were female and 25 (71.4%) were male. The size of the lesions ranged from 0.5 cm to 6.5 cm. The site of lesions included anogenital (8 cases, 22.8%), cutaneous (24 cases, 68.5%), and oral mucosal (3 cases, 8.5%) areas. Warts were found to be the most common lesions (14 cases, 40%), of which cutaneous warts comprised 9 cases (64%) and genital warts comprised 5 cases (36%). It was observed that benign warts were clinically confused with other rare cutaneous lesions such as polyps and cysts. Malignant counterpart of a wart or condyloma called as warty carcinoma was not known to many and was mistaken for a conventional squamous cell carcinoma. CONCLUSION: Histology is of utmost importance in differentiating the several verrucous lesions because sometimes clinical appearance may mimic one another.