Papillomatosis cutis carcinoides

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Papillomatosis cutis carcinoides

Postby patoco » Sat Jun 10, 2006 10:10 pm

Papillomatosis cutis carcinoides

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Papillomatosis cutis carcinoides

Related Terms: Verrucous Carcinoma, Squamous Cell Carcinoma, Epithelioma cuniculatum, Carcinoma cuniculatum

Late stage lymphedema, also commonly referred to elephantstasis can present with additional skin complications. One of these is a rare condition called papillomatosis cutis carcinoides. In appearance, this is similar to elephantiasis nostras verrucosa, which we discussed in our previous article.


The subcutaneous tissue becomes woody (intense fibrosis); venous flow is compromised and the dermal layers take on a cobblestone appearance from collagen placque. Small flesh colored or pink "bubbles" break out from the skin.

The important diagnostic tool to determine an accurate diagnosis, is a biopsy.

Papillomatosis cutis carcinoides accompanies both lymphatic filiarasis and extreme long term primary lymphedema.

Information availability in Engish is difficult to find.


Diagnostic Images - Papillomatosis cutis carcinoides ... a=N&tab=wi

Diagnostic Image #2

http://altmeyer.informatik.uni-wuerzbur ... 88601t.jpg


Verrucous Carcinoma

Verrucous carcinoma (VC) is a low-grade cutaneous squamous carcinoma which often presents on the foot where it is known as carcinoma cuniculatum


Epithelioma cuniculatum

Pub Med Links Page ... _uid=56941


Carcinoma cuniculatum

Pub Med Links Page ... &DB=pubmed


Congestive lymphostatic papillomatosis

Stoberl C, Partsch H.

Dermatologische Abteilung, KA-Rudolfstiftung Wien.

In seven patients with papillomatosis cutis in chronically congested lower extremities (lymphoedema, chronic venous insufficiency, chronic cardiac insufficiency) indirect lymphography revealed abnormalities of dermal lymph drainage. In four of these patients punch biopsies were taken from the papillomas. Microscopic examination revealed hyperplasia of the epidermis and dilated capillary-like vessels. Papillomatosis cutis in chronically congested lower extremities can be distinguished from pseudoepitheliomatose and carcinomatose alterations by both clinical and histological examination. Impaired local lymph transport seems to be the decisive trigger mechanism for the development of these papillomas.

PMID: 3220758 [PubMed - indexed for MEDLINE] ... =iconabstr


Tumor form of lymphostatic papillomatosis of the skin

[Article in German]

Niederauer HH, Schultz-Ehrenburg U, Tiedjen KU.

Abteilung Allgemeine Dermatologie mit Schwerpunkt Histopathologie und Angiologie, Ruhr-Universitat im St. Josef-Hospital Bochum.

The case of a patient with two plantar papillomatous tumours that had had a relapsing course over 10 years is presented. The tumours were located on the right forefoot and the left great toe. Several operations were performed for different diagnoses, i.e. plantar verrucae, verrucous carcinoma and pyoderma vegetans. Histologically, the papillomas proved to be pseudocarcinomatous hyperplasias with multiple ectatic dermal lymph plexuses. Indirect lymphography revealed a circumscribed lymphatic dysplasia with cystic-ectatic cutaneous vessels within the tumour area. Draining lymphatic collectors were conspicuously reduced in number. Isotope lymphography showed a normal lymph transport rate from the foot to the groin. It is concluded that the circumscribed disturbance of lymphatic drainage is the decisive cause of the reactive papillomatous hyperplasia. Thus, these papillomas clinically resembling verrucous carcinoma represent the tumour variant of a papillomatosis cutis lymphostatica.

Publication Types:
Case Reports

PMID: 1917474 [PubMed - indexed for MEDLINE] ... =iconabstr

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Epithelioma Cuniculatum (Verrucous Carcinoma)

Postby patoco » Sun Aug 27, 2006 9:27 pm

Journal of the American Podiatric Medical Association
Volume 96 Number 2 148-153 2006
Copyright © 2006 American Podiatric Medical Association

Recalcitrant Verrucous Lesion

Verrucous Hyperplasia or Epithelioma Cuniculatum (Verrucous Carcinoma)

Shahrooz S. Kelishadi, MD *, Garrett A. Wirth, MD and Gregory R. D. Evans, MD
* Department of General Surgery, University of Maryland, Baltimore.
Aesthetic and Plastic Surgery Institute, University of California at Irvine, Orange.

Corresponding author: Gregory R. D. Evans, MD, Aesthetic and Plastic Surgery Institute, University of California at Irvine, Manchester Pavilion, 200 S Manchester Ave, Ste 650, Orange, CA 92868-3298.


A 37-year-old woman originally presented in May 2003 with a nonhealing, painless ulcer on the plantar surface of her right foot that had been slowly increasing in size for the previous 1.5 years. Two weeks before presentation, a biopsy of the lesion, performed at another institution, had indicated a probable verrucous carcinoma. After preoperative workup, the patient underwent resection of the lesion, with clear margins and full-thickness skin grafting. The final pathologic findings were not consistent with verrucous carcinoma. A recurrent lesion was noted during a follow-up visit, and a second biopsy revealed a hyperkeratotic papillomatous verrucous lesion, type unclassified. No viral particles were isolated in the random biopsy samples. This recurrent lesion was refractory to treatment with topical acyclovir. Subsequent treatments consisted of imiquimod and CO2 laser ablation, which succeeded in reducing the lesion. Verrucous lesions can be frustrating, and the diagnosis of epithelioma cuniculatum can be difficult to prove. We report a case highly suggestive of but not definitively diagnosed as epithelioma cuniculatum and summarize the literature on this entity. (J Am Podiatr Med Assoc 96(2): 148–153, 2006) ... t/96/2/148
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