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Case Reports
. 2020 Sep 26;8(18):4094-4099.
doi: 10.12998/wjcc.v8.i18.4094.

Epidermolytic acanthoma: A case report

Ariana S Ginsberg  1 , Archeta Rajagopalan  1 , Joseph P Terlizzi  1
Affiliations
Case Reports

Epidermolytic acanthoma: A case report

Ariana S Ginsberg et al. World J Clin Cases. .

Abstract

Background: Epidermolytic acanthoma (EA) is a rare benign skin lesion, usually found in the genital area of men and women, with epidermolytic hyperkeratosis as its distinguishing histologic characteristic. It is commonly misdiagnosed as condyloma accuminatum, verruca, and seborrheic keratosis. Since this lesion is benign, treatment is not necessary. However, it is often misdiagnosed, and patients are likely to undergo incorrect counseling and unnecessary treatment, causing undue burden to the patient. This study seeks to increase awareness of this rare condition to prevent future misdiagnoses.

Case summary: A 55-year-old man living with human immunodeficiency virus presented for anal cancer screening. His physical examination revealed a flesh colored papule at the anal margin. The initial differential diagnosis included molluscum contagiosum, anal condyloma, and basal cell carcinoma. The lesion was excised to obtain a definitive diagnosis and was discovered to be EA.

Conclusion: EA is often misdiagnosed due to its similarity to other dermatologic conditions. Careful examination and pathologic evaluation should be obtained to ensure proper diagnosis.

Keywords: Anal cancer; Case report; Condyloma accuminatum; Epidermolytic acanthoma; Epidermolytic hyperkeratosis; Verruca.

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Conflict of interest statement

Conflict-of-interest statement: None to report.

Figures

Figure 1
Figure 1
External inspection of the anus demonstrates a pale colored papule three millimeters in size located one centimeter from the anal verge at the right anterior position (left panel). Magnified view of the lesion with high high resolution anoscopy shows a smooth, well-demarcated perianal lesion (right panel). The right panel shows the same lesion as the left panel at a higher magnification. The magnified photo was taken through a clear anoscope that was used to flatten out the perianal skin folds. The shine is a result of the lubricating gel.
Figure 2
Figure 2
Hematoxylin and eosin photomicrographs of the leison. The left panel demonstrates compact hyperkeratosis (yellow star) and acanthosis (orange arrow), with the formation of keratin crypts. Higher magnification (right panel) shows intracellular vacuolar degeneration of the epithelial cells of the spinous cell layer, as indicated by the orange arrows.
See this image and copyright information in PMC

References

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