Regardless of location or associated HPV type, these lesions are typically lined by an acanthotic
squamous epithelium with other obvious changes associated with verrucous lesions, which include hypergranulosis, with large, dense, coalescing keratohyaline granules, and occasional koilocytosis.
Histiocytes and lymphocytes surrounded superficial dermal blood vessels, and the epidermis appeared to be acanthotic
with orthokeratotic hyperkeratosis as well as a focal area of superficial ulceration of the keratin layer.
The epidermis surrounding the crater is acanthotic
A punch biopsy obtained from the right forearm revealed an acanthotic
epidermis with multifocal cytoplasmic vacuolization in the cells of the upper level kerat inocytes and prominent keratohyalin granules.
A shave biopsy of a neck plaque identified a hyperkeratotic, acanthotic
, spongiotic dermatitis with lymphocytes and scattered eosinophils.