The ages range from 50 to 80 years with a male predominance and a median age of 67 years. VC may grow large in size, resulting in the destruction of adjacent tissue, such as bone and cartilage. Diagnosis
Surgeons must provide adequate specimens including the full thickness of the tumors and adjacent uninvolved mucosa for correct histopathology diagnosis. Subtypes
Epithelioma cuniculatum (also known as Carcinoma cuniculatum,: 654  and Ackerman tumor) is a subtype of verrucous carcinoma, characterized by well-differentiated epithelial cells which lack cytological atypia, but display a blunt papillary/pebbly surface and keratin-filled crypts extending deep into the connective tissue. These keratin-filled resemble rabbit burrows. It is located almost exclusively on the foot, but at least oral location has also been described. Treatment
Surgery is considered the treatment of choice, but the extent of surgical margin and the adjuvant radiotherapy are still controversial. Surgical excision alone is effective for controlling VC, but elective neck dissection is not necessary even in patients in the advanced stages. Prognosis
Most patients with verrucous carcinoma have a good prognosis. Local recurrence is not uncommon, but metastasis to distant parts of the body is rare. Patients with oral verrucous carcinoma may be at greater risk of a second oral squamous cell carcinoma, for which the prognosis is worse. See also
List of cutaneous conditions
List of verrucous carcinoma subtypes

References
External links
eMedicine.com article
Since these effects are dose-related, in general it is advised to start with a low dose and gradually increase the dose to the desired amount. One study found that gastrointestinal side effects decreased significantly (from 50% to 15%) over 24 weeks, even on constant dosing.If a patient using acarbose has a bout of hypoglycemia, the patient must eat something containing monosaccharides, such as glucose tablets or gel (GlucoBurst, Insta-Glucose, Glutose, Level One) and a doctor should be called. Because acarbose blocks the breakdown of table sugar and other complex sugars, fruit juice or starchy foods will not effectively reverse a hypoglycemic episode in a patient taking acarbose.Hepatitis has been reported with acarbose use. It usually goes away when the medicine is stopped. Therefore, liver enzymes should be checked before and during use of this medicine. Life extension
In studies conducted by three independent laboratories by the US National Institute on Agings intervention testing programme, acarbose was shown to extend the lifespan of female mice by 5% and of male mice by 22%. Metabolism
Acarbose degradation is the unique feature of glycoside hydrolases in gut microbiota, acarbose degrading glucosidase, which hydrolyze acarbose into an acarviosine-glucose and glucose. Human enzymes do transform acarbose: the pancreatic alpha-amylase is able to perform a rearrangement reaction, moving the glucose unit in the "tail" maltose to the "head" of the molecule. Analog drugs with the "tail" glucose removed or flipped to an α(1-6) linkage resist this transformation.It has been reported that the maltogenic alpha-amylase from Thermus sp.