10.5826/dpc.1201a39
text/xml
2160-9381
1823
en
Álvaro Abarzúa-Araya
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Not Every Isolated Plantar Lesion Is a Wart: A Case of Pagetoid Reticulosis Presenting as an Acral Lesion
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-02-02
2021-06-06
2022-02-02
2022-02-09
e2022039
Dermatol Pract Concept
Álvaro Abarzúa-Araya
2022/02/02
10.5826/dpc.1201a39
e2022039
Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
2160-9381
en
e2022039
Zalaudek I. Dermoscopy in general dermatology. In: Marghoob AA, Malvehy J, Braun RP (eds). An Atlas of Dermoscopy. 2nd ed: Informa Healthcare; 2012: 325-336
Not Every Isolated Plantar Lesion Is a Wart: A Case of Pagetoid Reticulosis Presenting as an Acral Lesion
https://dpcj.org/index.php/dpc/article/download/1823/1480
           Not Every Isolated Plantar Lesion Is a Wart:
            A Case of Pagetoid Reticulosis Presenting
                       as an Acral Lesion
          Leonel Hidalgo1, Miguel Villaseca-Hernández1,2, Cristián Navarrete-Dechent1,3,
                                    Álvaro Abarzúa-Araya1,3


1 Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
2 Department of Pathology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
3 Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile



Citation: Hidalgo L, Villaseca-Hernández M, Navarrete-Dechent C, Abarzúa-Araya A. Not every isolated plantar lesion is a wart:
a case of pagetoid reticulosis presenting as an acral lesion. Dermatol Pract Concept. 2022;12(1):e2022039.
DOI: https://doi.org/10.5826/dpc.1201a39
Accepted: July 8, 2021; Published: January 2022
Copyright: ©2022 Hidalgo et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Álvaro Abarzúa-Araya, MD, Department of Dermatology, Escuela de Medicina Pontificia Universidad Católica de
Chile, Santiago, Chile. E-mail: alvaroabarzuaaraya@gmail.com




Case Presentation                                                        misdiagnosed as dermatitis or psoriasis [1]. Dermoscopy
                                                                         provides diagnostic clues: plantar warts show disruption of
A 52-year-old woman was referred for a plantar wart. She                 dermatoglyphics and irregular capillaries due to weight bear-
reported a 2-month asymptomatic lesion on the right foot                 ing and trauma; calluses demonstrate homogenous opacities;
(Figure 1, A and B). Based on examination, surgery was per-              corns exhibit a translucent core; Bowen disease has scale and
formed to rule-out a malignant neoplasm. The histopatho-                 glomerular vessels in clusters [2]. In this case dermoscopy
logical features and immunostaining were consistent with                 showed a white hyperkeratotic center, aligned red dots, and
pagetoid reticulosis (PR) (Figure 1, C and D).                           slight-pinkish background. Prior reports of PR described reg-
                                                                         ular dotted and glomerular vessels in a pinkish background,

Teaching Point                                                           vessels halos, and scales [1].


PR is a rare variant of mycosis fungoides, manifesting                   Informed consent: Informed consent for publication of clini-
as solitary indolent scaly or verrucous plaque frequently                cal details and clinical images was obtained from the patient.




Image Letter | Dermatol Pract Concept. 2022;12(1):e2022039                                                                           1
Figure 1. (A) Reticuloid pagetosis. A 1-cm skin colored hyperkeratotic papule in the lateral surface of the right foot. (B) Reticuloid pagetosis.
Dermoscopy revealed a white hyperkeratotic center surrounded by aligned red dots amidst a slight-pinkish background (polarized dermos-
copy, x10). (C) Reticuloid pagetosis. Photomicrograph showing hyperkeratosis and atypical lymphocytes with intense epidermotropism
(H&E x 40). (D) Reticuloid pagetosis. Immunostain were positive for CD3, CD4, and CD8.




References                                                                 2. Zalaudek I. Dermoscopy in general dermatology. In: Marghoob
                                                                              AA, Malvehy J, Braun RP (eds). An Atlas of Dermoscopy. 2nd ed:
1. Manoli SM, Lallas A, Ioannides D, et al. Dermoscopy of page-               Informa Healthcare; 2012: 325-336
   toid reticulosis, with dermoscopic-pathologic correlation. Photo-
   dermatol Photoimmunol Photomed. 2019;35(5):372-374. DOI:
   10.1111/phpp.12472. PMID: 31006145.




2                                                                                 Image Letter | Dermatol Pract Concept. 2022;12(1):e2022039
