Hypergranulotic Dyscornification – Alba Variant

Hypergranulotic dyscornification (HGD) represents a unique histopathologic reaction pattern with disorder in the maturation of corneocytes. Hypergranulotic dyscornification do not have specific clinical description so final diagnosis is entirely based on histological findings. A 69 yrs old man presented with multiple asymptomatic discrete depigmented papules and nodules with verrucous surface over the legs and hands of 3 months duration. Verruca vulgaris and seborrheic keratosis were provisional diagnosis based on surface verrucosity but could not explain the depigmentation. Histopathology revealed features of HGD. Special stain with Fontana Masson and immunohistochemistry with HMB-45 showed loss of melanocytes in lesional skin compared to normal skin which explained depigmentation. This case of HGD is reported for its rarity and additional finding of depigmentation which has not been reported so far in the literature. The diagnosis of HGD Albicans or with co-occurrence of vitiligo remains to be seen with further reports.