Epidermolytic acanthomas are a cutaneous condition characterized by discrete keratotic papules in adults. Epidermolytic acanthomas may exist in groups or as solitary lesions. They range in size from 1-2 mm. They usually affect the trunk, extremities,

scrotum The scrotum or scrotal sac is an anatomical male reproductive structure located at the base of the penis that consists of a suspended dual-chambered sac of skin and smooth muscle. It is present in most terrestrial male mammals. The scrotum co ...

, or

vulva The vulva (plural: vulvas or vulvae; derived from Latin for wrapper or covering) consists of the external female sex organs. The vulva includes the mons pubis (or mons veneris), labia majora, labia minora, clitoris, vestibular bulbs, vulv ...

. They are sometimes itchy. The cause of epidermolytic acanthoma is unknown. Epidermolytic acanthoma is diagnosed based off clinical and histological signs.

Epidermolytic hyperkeratosis Epidermolytic ichthyosis (EI), also known as bullous epidermis ichthyosis (BEI), epidermolytic hyperkeratosis (EHK), bullous congenital ichthyosiform erythroderma (BCIE), bullous ichthyosiform erythrodermaFreedberg, et al. (2003). ''Fitzpatrick' ...

is the main characteristic of epidermolytic acanthoma. Treatment isn't needed.

Signs and symptoms

Epidermolytic acanthoma manifests clinically as tiny, fleshy or white

papules A papule is a small, well-defined bump in the skin. It may have a rounded, pointed or flat top, and may have a dip. It can appear with a stalk, be thread-like or look warty. It can be soft or firm and its surface may be rough or smooth. Some h ...

that range in size from 1 to 2 mm. They may exist alone or in groups. They often affect the trunk, extremities, or

and

. Although they can be itchy, they are frequently asymptomatic, and the chronic type can result in lichenification.

Causes

The exact cause of the lesion is unknown. There have been suggestions that epidermolytic acanthoma could represent a localized form of generalized hereditary

epidermolytic hyperkeratosis Epidermolytic ichthyosis (EI), also known as bullous epidermis ichthyosis (BEI), epidermolytic hyperkeratosis (EHK), bullous congenital ichthyosiform erythroderma (BCIE), bullous ichthyosiform erythrodermaFreedberg, et al. (2003). ''Fitzpatrick' ...

. While some have searched for a connection between

HPV Human papillomavirus infection (HPV infection) is caused by a DNA virus from the '' Papillomaviridae'' family. Many HPV infections cause no symptoms and 90% resolve spontaneously within two years. In some cases, an HPV infection persists and re ...

and epidermolytic acanthoma, they have not consistently found one. Epidermolytic acanthoma typically affects people who have never had an STD and who have never engaged in unsafe sexual conduct. There has also been weak evidence to support the suggestions of trauma or continuous scratching. Some expressed the belief that

immunosuppression Immunosuppression is a reduction of the activation or efficacy of the immune system. Some portions of the immune system itself have immunosuppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse reacti ...

Diagnosis

The distinctive histologic findings in the appropriate clinical situation are necessary for an accurate diagnosis of epidermolytic acanthoma.

on over 50% of the epidermolytic acanthoma surface is the main histologic characteristic of the condition.

Keratinocytes Keratinocytes are the primary type of cell found in the epidermis, the outermost layer of the skin. In humans, they constitute 90% of epidermal skin cells. Basal cells in the basal layer (''stratum basale'') of the skin are sometimes referre ...

with coarse keratohyalin granules, reticular degeneration, perinuclear vacuolation, and perinuclear eosinophilic inclusions in the granular and spinous layers are characteristics of

Treatment

There is no need for treatment, but if the patient feels embarrassed, there are a number of different therapies that can be performed, with varying degrees of success, such as

cryotherapy Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy may be used to treat a variety of tissue lesions. The most prominent use of the term refers to the surgical treatment, s ...

, topical immune system modulators, or surgical excision.

References

External links

Pathology Outlines

VisualDx
{{Skin tumors, epidermis Epidermal nevi, neoplasms, and cysts