Warty dyskeratoma are benign adnexal neoplasms that typically present as isolated lesions on the head and neck. They have distinctive features microscopically, including a cup-shaped invagination with suprabasiliar acantholytic dyskeratosis, corp ronds and grains, and central keratotic plug. A patient presented with multiple, small perianal papules that were initially diagnosed as anal glands, then genital warts. When a biopsy was performed, the classic features of a warty dyskeratoma were seen. The patient was treated with topical calcipotriene which was helpful in reducing the size of the lesions. This case raises the possibility that perianal warty dyskeratomas may be more common than previously thought, which has significant implications for treatment and counseling of patients.
Mortelliti et al. (Sun,) studied this question.