Epidermolytic Acanthoma Research Articles

Acantoma epidermolitico da região escrotal

São apresentados dois casos de acantoma epidermolítico da região escrotal. Trata-se de homens com 52 e 68 anos de idade, tendo 21 e cinco lesões, respectivamente, todas assintomáticas. O exame anatomopatológico foi característico, mostrando hiperplasia da epiderme com alteração epidermolítica da porção superior da camada espinhosa, que se estende até a camada granulosa. Casos como esses não têm sido publicados, até aqui, no Brasil. O registro dos casos foi feito para despertar o interesse de dermatologistas e urologistas por uma afecção que não parece ser tão rara, conforme tem sido afirmado.

Granular Parakeratotic Acanthoma

Granular parakeratosis was originally described as a dermatosis confined to the axillae that histopathologically shows characteristic findings in the cornified layer consisting of parakeratotic corneocytes housing keratohyaline granules. Since the original description of this entity, non-intertriginous examples and even incidental foci of granular parakeratotic corneocytes in association with other dermatoses have been recognized. This report details the findings of a previously unreported entity that we are naming granular parakeratotic acanthoma, which is fundamentally akin to acantholytic dyskeratotic acanthoma and epidermolytic acanthoma (ie, a solitary keratosis that histopathologically displays features indicated in its name).

Verruciform Xanthoma in Close Association with Isolated Epidermolytic Acanthoma: A Case Report and Review of the Japanese Dermatological Literature

A 52-year-old man presented to our department with a scrotal skin nodule, first noted as a papule two to three years previously. The nodule was red and pedunculated with a granular surface and a diameter of 10 mm. Three red papules were scattered around the nodule. Histopathologic examination of the nodule showed epidermal papillary hyperplasia, collections of foam cells in the papillary dermis, and a dense infiltration of inflammatory cells into all dermal layers. In addition, granular degeneration was seen in the pedunculated lesion of the nodule free from the foam cells. Microscopic examination of the red papules also showed granular degeneration. The patient was diagnosed with verruciform xanthoma associated with isolated epidermolytic acanthoma. This is the first report of these two lesions occurring at the same site on the scrotum.

A case of isolated epidermolytic acanthoma on the neck

Five or more dermpath cases will be presented in poster format. Classic and rare cases, each with instructive points or diagnostic pitfalls, will be chosen. The clinical history will be described and representative images of the histopathology displayed. Viewers may take the opportunity to develop a differential diagnosis before unmasking the concealed diagnoses accompanied by a review of the teaching points and references.

局所多発性Ｅｐｉｄｅｒｍｏｌｙｔｉｃ Ａｃａｎｔｈｏｍａ

A 68-year-old man presented with more than 30 brownish papules up to 2 mm in diameter on the penis. Histologically, there were marked hyperkeratosis and acanthosis with prominent granular degeneration. The eruption was diagnosed as localized multiple epidermolytic acanthoma. We immunohistochemically studied the expression of various antigens in the specimen along with epidermal nevus with granular degeneration, exhibiting bullous congenital icthyosiform erythroderma, and normal skin. Cytokeratin (CK) 10 and CK1 were not homogeneously distributed in the disordered granular layer, in comparison with the normal granular layer. CK17 was partly stained in the granular layer of the localized multiple epidermolytic acanthoma, but not in the other two diseases, carcinoembryonic antigen was expressed not only in the disordered granular layer but also in the adjacent normal-appearing granular layer. Therefore, we considered that the epidermis surrounding the papules had the same abnormality as the lesional skin.

Disseminated Epidermolytic Acanthoma with Disseminated Superficial Porokeratosis and Verruca Vulgaris in an Immunosuppressed Patient

A 40-year-old man who had received long term immunosuppressive treatment for 14 years following kidney transplantation developed multiple skin lesions on both antecubital fossae, scalp, and both lower extremities. Histopathologic findings from three skin regions revealed characteristic features of epidermolytic hyperkeratosis, verruca vulgaris, and disseminated superficial porokeratosis, respectively. Although immunocompromised individuals may demonstrate verruca vulgaris or porokeratosis, disseminated epidermolytic acanthoma (DEA) has not been reported to be associated with immunosuppressed status. We suggest that immunosuppression may play a role in the pathogenesis of DEA, as shown in our case.

Disseminated Epidermolytic Acanthoma

A 57-year-old man developed hundreds of light brown, slightly atrophic papules, which were distributed diffusely over the back. Although clinically the lesions resembled seborrheic keratoses, histologic examination demonstrated changes of epidermolytic hyperkeratosis. The patient had neither a personal nor a family history of ichthyosiform disorders. The diagnosis of disseminated epidermolytic acanthoma was made in the context of the clinical, histologic, and historical features. Disseminated epidermolytic acanthoma is a rare condition that is readily diagnosable using clinicopathologic correlation; it is important to exclude it from other more serious conditions associated with epidermolytic hyperkeratosis.

Epidermolytic acanthoma does not contain human papillomavirus DNA.

The histologic changes of epidermolytic acanthoma can mimic those of human papillomavirus infection. Sections from paraffin-embedded tissues identified histologically as epidermolytic acanthoma were examined for the presence of human papillomavirus (HPV) types 6, 11, 16, 18, and 33 using the polymerase chain reaction followed by dot-blot analysis with specific radiolabelled detecting probes. Although present in appropriate controls, human papillomavirus DNA was not detected in epidermolytic acanthoma. We conclude that epidermolytic acanthoma is not a skin lesion that is associated with human papillomavirus infection.

Acantholytic acanthoma

This article describes 31 examples of acantholytic acanthoma, a newly recognized, solitary, benign cutaneous tumor. Acantholytic acanthoma was typically an asymptomatic, keratotic papule or nodule. Patients ranged in age from 32 to 87 years (median 60 years); the ratio of men to women was 2:1; the most frequent clinical diagnosis was keratosis; and half of the growths were on the trunk of the body. Histologically, the lesions showed hyperkeratosis, papillomatosis, and acanthosis. Acantholysis was an outstanding finding in all cases; the patterns resembled pemphigus vulgaris, pemphigus vegetans, superficial pemphigus, or Hailey-Hailey disease, but no patient had evidence of any of these disorders. The term acantholytic is used because acantholysis is the outstanding histologic feature in these neoplasms; acanthoma was chosen because the growths are benign tumors of epidermal keratinocytes. The relationship of acantholytic acanthoma to acantholytic blistering disease is similar to that of solitary lichen planus-like keratosis to lichen planus and epidermolytic acanthoma to bullous congenital ichthyosiform erythroderma.

Vulvar Localisation of Epidermolytic Acanthoma

A patient had several verrucoid lesions on the vulva, which showed light- and electron-microscopic features of epidermolytic acanthoma.

The benign acanthomas.

An important, yet neglected, problem in dermatopathology, is the evaluation of the benign acanthomas, the benign tumors of epidermal keratinocytes. The benign acanthomas may be simulated by lesions which are not benign (e.g. actinic keratosis), not tumors (e.g. normal plantar skin), or are not epidermal (e.g. dermatofibroma). In addition to normal (epidermoid) keratinization (e.g., seborrheic keratosis and related conditions), the variants of the benign acanthomas show a wide range of aberrant keratinization, including epidermolytic hyperkeratosis (epidermolytic acanthoma), dyskeratosis (warty dyskeratoma), acantholysis (acantholytic acanthoma), cornoid lamellation (porokeratosis), lichenoid hyperplasia (lichen planus-like keratosis), and absence of keratinization (clear cell acanthoma).

Isolated Epidermolytic Acanthoma

A solitary scrotal lesion of isolated epidermolytic acanthoma was studied by optical microscopy. The lesion displayed typical granular degeneration. The tumor parenchyma comprised several foci extending deep in the cutis to the continuation of the invaginated epithelium. Serial sections showed the parenchyma was free from acrosyringium and epidermis proper. The findings with hematoxylin-eosin stain and Fontana-Masson stain indicated that the tumor had originated from portion B of the hair follicle.

Isolated Epidermolytic Acanthoma

Seven cases of a solitary tumor, with the histopathologic feature of granular degeneration, were identified as isolated epidermolytic acanthoma. Clinically the lesion is not diagnostic, but resembles a wart. It is apparently not heritable, although it shows the same microscopic features as the dominantly inherited dermatoses recently termed epidermolytic hyperkeratosis.

Isolated epidermolytic acanthoma. A solitary tumor showing granular degeneration.

Seven cases of a solitary tumor, with the histopathologic feature of granular degeneration, were identified as isolated epidermolytic acanthoma. Clinically the lesion is not diagnostic, but resembles a wart. It is apparently not heritable, although it shows the same microscopic features as the dominantly inherited dermatoses recently termed epidermolytic hyperkeratosis.