Warty Dyskeratoma
Christine J. Ko, MD
Key Facts
Clinical Issues
Solitary (very rarely multiple)
Umbilicated papule or nodule
Often on head or neck
Microscopic Pathology
Cup-shaped lesion
Sometimes associated with hair follicles
Hyperkeratosis and parakeratosis
Suprabasilar acantholysis with villi at base
Mixed inflammatory infiltrate in dermis
Corp ronds (round to slightly oval nucleus with pink cytoplasm) are present
Grains (raisinoid nuclei with pink cytoplasm) present
Minimal to no cytologic atypia
Top Differential Diagnoses
Darier disease
Acantholytic dyskeratotic acanthoma
Acantholytic squamous cell carcinoma
 This is a low-power view of a warty dyskeratoma, a cup-shaped lesion. There is hyperkeratosis and parakeratosis above central acantholytic dyskeratosis  with villi at the base  . |
 A high-power view shows the central acantholytic dyskeratosis in a warty dyskeratoma. There are corp ronds (central round to slightly oval shrunken nuclei with surrounding pink cytoplasm)  . |
TERMINOLOGY
Abbreviations
Warty dyskeratoma (WD)
Definitions
Cup-shaped epidermal proliferation
Acantholysis is present
Dyskeratosis (corp ronds and grains) is present
ETIOLOGY/PATHOGENESIS
Pathophysiology
Germline mutations in ATP2A2 not described (as are seen in Darier disease)
Human papilloma virus infection has not been associated with WD
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