Work

Pedunculated Acral Keratotic Papule on an Ischemic Foot

Year: 2026

Type: article

Abstract: An 86-year-old man presented with a slowly enlarging, subject to chronic mechanical irritation, pedunculated keratotic papule on the plantar tip of the right hallux in the setting of severe peripheral arterial disease. Excision was deferred until after endovascular revascularization to reduce the risk of nonhealing and limb complications, after which the lesion was removed without wound sequelae. Histopathology demonstrated a conical papule with a central collagenous core and an overlying cap of compact hyperkeratosis. This case highlights key clinicopathologic features that distinguish acral keratotic tumors and underscores the importance of perfusion optimization when planning elective excision on an ischemic limb.

Source: Dermatopathology

DOI: 10.3390/dermatopathology13020018

Authors: Janmesh D. Patel, Pooja A. Shet, Sara E. Dahle, Joshua M. Schulman, Marat D. Kazak

Institutions: VA Northern California Health Care System, Sacramento VA Medical Center, University of California Davis Medical Center

Language: English

Topic: Nonmelanoma Skin Cancer Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,810