Examination of the lesion at scanning magnification revealed marked verrucous acanthosis. Neutrophils were seen in the upper epidermal layers and within parakeratotic scale. Columns and lobules of acanthotic epithelium extended into the dermis. The dermal papillae were expanded, and the capillaries were mildly ectatic. Higher magnification revealed numerous lipid-laden foamy macrophages (xanthoma cells) within dermal papillae admixed with variable numbers of acute and chronic inflammatory cells, including lymphocytes, plasma cells, neutrophils, and occasional eosinophils.
A Persistent Lower Lip Lesion. Arch Dermatol. 2000;136(5):665-670. doi: