title: Necessity of Distinguishing Verrucous Carcinoma From Verrucous Skin Lesion Overlaying Residual Skin Staples in an Area of Sensory Loss: A Case Report.
abstract: OBJECTIVE
  Verrucous skin lesions on the feet in diabetic neuropathy is a condition usually induced by chronic mechanical stimulation of the feet of patients with diabetic neuropathy and usually occurs at weight-bearing sites. We here present a rare case involving a man with verrucous skin lesions on the feet in diabetic neuropathy at an unusual, non-weight-bearing site.
  
  
  METHODS
  A 58-year-old man with diabetic neuropathy presented with a verrucous skin lesion overlaying residual skin staples and an amputation stump of the second metatarsal bone on the dorsal foot.
  
  
  RESULTS
  The biopsy findings were inconclusive and suggested the necessity of distinguishing the lesion from verrucous carcinoma. The lesion was resected, and the residual skin staples were simultaneously removed. Investigation of the excisional biopsy confirmed our diagnosis of verrucous skin lesions on the feet in diabetic neuropathy.
  
  
  CONCLUSIONS
  Verrucous skin lesions on the feet in diabetic neuropathy is often difficult to distinguish from verrucous carcinoma; in this case, the unusual location of the lesion could be attributed not only to sensory loss but also to the presence of an amputation stump and the persistence of the residual skin staples.
authors.affiliation: Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sakakibara
authors.affiliation: Department of Plastic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tokiyoshi
authors.affiliation: Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Hashikawa
authors.affiliation: Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Terashi
keywords: VSLDN; diabetic foot; diabetic neuropathy; verrucous carcinoma; verrucous skin lesion