Differential diagnosis

Adult papillary keratosis reveals keratot-ic, hyperplastic squamous epithelium with keratohyaline granules, occasionally atypia, and absence of koilocytes {126}. Verrucous carcinoma exhibits thicker squamous fronds with prominent kerato-sis, bulbous rete pegs, that infiltrate in a blunt, pushing manner. Papillary squa-mous carcinoma usually presents an architecture similar to RRP, but is cyto-logically malignant. Laryngeal verruca vulgaris is extremely rare, and shows the same features as in the skin {138}.

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