Solitary epidermolytic acanthoma: a clinical and histopathological study

Abstract

This large case series of solitary EA reviews the clinical features of this entity and describes several new histological variants.

Multiple Localized Epidermolytic Acanthomas of the Vulva Associated With Vulvar Pruritus

“…4 It may mimic a wart or a seborrheic keratosis. 2,5 Other documented clinical presentations include pruritic, 5 umbilicated, 7 dome-shaped, flat-topped, 4 gray-white, 4,5 skin-colored, 8 brown, 7 and red 9 papules or a plaque. 5 EA most commonly presents in adulthood 4 but has been described in patients of all ages from 3 to 88.…”

“…1 First described by Shapiro and Baraf in 1970, epidermolytic acanthoma (EA) is a benign acquired variant characterized histologically by epidermolytic hyperkeratosis (EH). 2,3 The hallmarks of EH are vacuolar and reticular degeneration of keratinocytes in the spinous and granular layers, compact hyperkeratosis, hypergranulosis, and the presence of amorphous eosinophilic trichohyalinelike granules. EH is not specific to EA and is described in various genetic and acquired, localized, and generalized disorders.…”

“…The hereditary skin diseases include bullous congenital ichthyosiform erythroderma, hereditary palmoplantar keratoderma of Vorner, and systemized or linear epidermal nevi. 2,4 The acquired dermatoses include isolated and disseminated EA. 2 Focal nonspecific changes of EH have also been reported as an incidental finding in some inflammatory and benign/malignant lesions (such as seborrheic keratosis, basal cell carcinoma, and intradermal nevus) or in their vicinity and even in normal looking skin.…”

“…2 Focal nonspecific changes of EH have also been reported as an incidental finding in some inflammatory and benign/malignant lesions (such as seborrheic keratosis, basal cell carcinoma, and intradermal nevus) or in their vicinity and even in normal looking skin. 2,5 Four histological patterns of EA have been described consisting of the papillomatous, cupshaped, acanthomatous, 2 and the recently described polypoid variant. 6 These histological patterns are nonexclusive and may coexist within the same lesion.…”

“…6 These histological patterns are nonexclusive and may coexist within the same lesion. 2 EA of the female genitalia is a rare diagnosis with only a few cases reported in the literature. We report the case of multiple localized EAs on the vulva of a 31-year-old woman who presented with vulvar pruritus and review the previous vulvar cases reported in the literature.…”