Verruca Vulgaris

A 74-year-old man sought medical attention for a lesion on his right arm, near the elbow. His medical history included many actinic keratoses, multiple non-melanoma skin cancers, and a malignant melanoma.

Key point: A 2 x 2-cm, non-tender, rock hard nodule was found on the posteromedial aspect of the right arm. The surface was covered by a thick, yellow keratin layer. The clinical suspicion was squamous cell carcinoma, but a deep punch biopsy disclosed only verruca vulgaris.

Treatment: Treatment consisted of sharp curettage followed by electrodesiccation. The curettage material verified the benign diagnosis.

Note: A biopsy is more often than not indicated, before definitive treatment is entertained, to determine the correct diagnosis. This lesion might have been over-treated as a presumed squamous cell carcinoma had not a biopsy been obtained.