Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 4094-4099
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4094
Epidermolytic acanthoma: A case report
Ariana S Ginsberg, Archeta Rajagopalan, Joseph P Terlizzi
Ariana S Ginsberg, Archeta Rajagopalan, Joseph P Terlizzi, Department of Colon and Rectal Surgery, Laser Surgery Care, New York, NY 10011, United States
Joseph P Terlizzi, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Author contributions: Terlizzi JP examined and treated the patient and conceived the original idea for the paper; Ginsberg AS and Rajagopalan A completed the literature report; Terlizzi JP, Ginsberg AS, and Rajagopalan A wrote the case presentation; Ginsberg AS and Rajagopalan A then wrote the manuscript with support and supervision from Terlizzi JP; all authors were responsible for the revision of the manuscript and have reviewed the paper for accuracy; Ginsberg AS and Rajagopalan A contributed equally to the manuscript.
Informed consent statement: All involved persons gave their informed consent prior to examination and treatment for this case report.
Conflict-of-interest statement: None to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Joseph P Terlizzi, MD, Surgeon, Department of Colon and Rectal Surgery, Laser Surgery Care, 420 W 23rd St Suite PB, New York, NY 10011, United States. joseph.terlizzi@mountsinai.org
Received: March 2, 2020
Peer-review started: March 2, 2020
First decision: April 22, 2020
Revised: June 26, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: September 26, 2020
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: Epidermolytic acanthoma, Epidermolytic hyperkeratosis, Condyloma accuminatum, Anal cancer, Verruca, Case report

Core Tip: Epidermolytic acanthomas (EAs) are papular skin lesions whose hallmark histologic feature is EHK. Herein, we describe a patient who presented with a solitary perianal EA and summarize the existing literature. EAs often present as pale papules in the genital region, trunk and extremities. EA is benign and cannot be spread to others, however they are commonly misdiagnosed as condyloma accuminatum, verruca, and seborrheic keratosis. Careful histopathological examination is necessary to obtain an accurate diagnosis and prevent unnecessary treatments. Although treatment of EA is not medically necessary, many patients prefer treatment, which can be accomplished with topical therapy or with excision.