M. Vulvar verruciform xanthoma: ten cases associated with lichen sclerosus, lichen planus, or other conditions. Arch Dermatol. 2011;147(9):1087-1092. 2. Lu S, Rohwedder A, Murphy M, Carlson JA. Verruciform xanthoma: localized lymphedema (elephantiasis) is an essential pathogenic factor. J Cutan Pathol. 2011. 3. Lu S, Tran TA, Jones DM, et al. Localized lymphedema (elephantiasis): a case series and review of the literature. J Cutan Pathol. 2009;36(1):1-20. 4. Paul J, Carlson JA. Lymphangiectases

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... are common underlying warts and in normal peritumoral skin: histologic evidence of decreased immune surveillance. Am J Dermatopathol. 2011;33(2):152-160. 5. Carlson JA, Malfetano J, Rohwedder A. Genital and epidermodysplasia verruciformis associated HPV DNA is frequently found in lichen sclerosus [abstract]. ). Report of a Case. A healthy 40-year-old white woman presented with a reticular erythematous and hyperpigmented rash restricted to the posterior thighs (Figure 1 ).