Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4094
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
Processing time: 203 Days and 3.5 Hours
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.
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.
EA is often misdiagnosed due to its similarity to other dermatologic conditions. Careful examination and pathologic evaluation should be obtained to ensure proper diagnosis.
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.