The American Society of Dermatopathology

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Interactive Case Study - June 2014

A persistent gluteal plaque

Megan S. Evans, MD; Sara C. Shalin, MD, PhD

Question 1:

A 71-year-old man with a history of psoriasis presented with a five-year history of a pruritic gluteal plaque that persisted despite treatment with topical and intralesional corticosteroids. Examination revealed a verrucous plaque localized symmetrically within the gluteal cleft. Shave biopsy was performed for diagnosis. The histopathology is shown below (Figures 1-3).

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Figure 1

Figure 2

Figure 3

Which of the following is the best diagnosis?