title: Verrucous localized lymphedema of genital areas: clinicopathologic report of 18 cases of this rare entity.
abstract: BACKGROUND
  Localized lymphedema is a nonneoplastic condition associated with obesity and predominantly involving the legs. This condition has distinctive clinical and histologic features and only rarely has been mentioned in the dermatologic literature.
  
  
  OBJECTIVE
  We sought to evaluate the clinical and histopathologic features.
  
  
  METHODS
  The clinicopathologic features in patients with localized lymphedema of the genital region were studied.
  
  
  RESULTS
  We identified 18 patients with localized lymphedema clinically presenting as large polypoid or verrucous lesions. The patients were 5 men and 13 women with a mean age of 46.5 years. Twelve patients were obese at diagnosis. Thirteen patients presented with tumors involving the vulva, 4 patients with tumors in the penis and scrotum, and 1 patient with scrotal and pubic lesions. Histologically, all cases showed marked dermal edema along with dilated lymphatic spaces, fibroplasia, and verrucous epidermal changes (papillomatous and hyperplastic epidermis).
  
  
  CONCLUSIONS
  Only 18 cases were included in our study.
  
  
  CONCLUSIONS
  This condition is an uncommon and recently described entity that could potentially be clinically and histologically misdiagnosed as a neoplasm; thus, it needs to be included in the differential diagnosis of polypoid and verrucous skin tumors with extensive dermal edema and fibroplasia.
authors.affiliation: Division of Dermatopathology, Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: jplaza@mcw.edu.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Plaza
authors.affiliation: Department of Dermatology, Universidad Autonoma de Madrid, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Requena
authors.affiliation: Sikls's Department of Pathology Charles University Medical Faculty Hospital, Pilsen, Czech Republic.
authors.forename: Dmitry V
authors.initials: DV
authors.lastname: Kazakov
authors.affiliation: Department of Dermatology, Hospital General "Dr Manuel Gea González," Mexico City, Mexico.
authors.forename: Elisa
authors.initials: E
authors.lastname: Vega
authors.affiliation: Sikls's Department of Pathology Charles University Medical Faculty Hospital, Pilsen, Czech Republic.
authors.forename: Denisa
authors.initials: D
authors.lastname: Kacerovska
authors.affiliation: Department of Dermatology, Hospital General "Dr Manuel Gea González," Mexico City, Mexico.
authors.forename: Gisela
authors.initials: G
authors.lastname: Reyes
authors.affiliation: Sikls's Department of Pathology Charles University Medical Faculty Hospital, Pilsen, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Michal
authors.affiliation: Division of Dermatopathology, Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Saul
authors.initials: S
authors.lastname: Suster
authors.affiliation: Hospital Obrero, La Paz, Bolivia.
authors.forename: Martin
authors.initials: M
authors.lastname: Sangueza
mesh_terms: D000328:Adult; D000368:Aged; D004487:Edema / Q000150:complications*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010412:Penile Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D012611:Scrotum; D012871:Skin Diseases / Q000150:complications / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000150:complications*
keywords: localized lymphedema; massive localized lymphedema; penile lymphedema; scrotal lymphedema; vulvar lymphedema