Abstract
Introduction: Large cell acanthoma (LCA) is a rare benign tumor of epidermal origin. It is mainly seen on sun-exposed areas such as the head and extremities of older patients. Histopathologically, LCA is characterized by acanthosis and keratinocytes that are twice as large as normal cells. We herein report a case involving a child diagnosed with LCA on an unexposed area of skin. Case presentation: A 10-year-old boy presented with a rough, painless light brown papule on his right chest that had been present for 11 months. He underwent surgical resection and pathological examination, and the histopathological findings were consistent with LCA. Discussion: LCA is common in adults but rare in children. It is difficult to differentiate from solar lentigo, actinic keratosis, or seborrheic keratosis because of its atypical clinical presentation. Dermoscopy, reflectance confocal microscopy, and cellular-resolution full-field optical coherence tomography can be used as auxiliary examinations, but pathological biopsy is still required to confirm the diagnosis. Conclusion: LCA is not limited to adults and exposed areas. This case reminds us that LCA may occur in children and that close attention is required for its identification.
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