Multiple epidermolytic acanthomas mimicking condyloma: A retrospective study of 8 cases

Tsung Ju Lee, Yu Hung Wu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Epidermolytic acanthoma (EA) is an uncommon benign cutaneous lesion. Multiple epidermolytic acanthomas (multiple EAs) are rarely reported. Methods We retrospectively identified patients diagnosed with multiple EAs between 2005 and 2017 from our dermatopathology database and analyzed their clinical, pathological, and immunohistochemical features. We also evaluated the association of multiple EAs with human papillomavirus (HPV) infection. Results In total, eight patients (average age 51 years; 3: 1 male predominance) with multiple EAs were found. All patients had lesions on the genitocrural area. The two most common clinical diagnoses were condyloma (5/8) and soft fibroma (3/8), which were predominantly skin-colored (5/8) or whitish (2/8). The lesions were less than 1 cm in diameter, and most (6/8) appeared to have a smooth surface. No molecular evidence suggesting HPV infection was found. Immunohistochemical staining showed low mitotic activity. The lesions were removed in one of two patients via cryotherapy, and one patient was treated with electrocauterization. The other five patients were followed without treatment. Conclusion The genital area was the most common location for multiple EAs, which was commonly misdiagnosed clinically as condyloma. Patients presenting with uniformly small-sized, skin-colored to whitish, smooth papular lesions in the genitalia should be carefully evaluated. The specific pathological features of epidermolytic hyperkeratosis are diagnostic, and the lesions can be observed without aggressive treatment after confirmed diagnosis.

Original languageEnglish
Pages (from-to)28-33
Number of pages6
JournalInternational Journal of Dermatology
Volume57
Issue number1
DOIs
Publication statusPublished - Jan 1 2018
Externally publishedYes

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Acanthoma
Retrospective Studies
Papillomavirus Infections
Skin
Epidermolytic Hyperkeratosis
Cryotherapy
Genitalia
Fibroma
Diagnostic Errors
Databases
Staining and Labeling

ASJC Scopus subject areas

  • Dermatology

Cite this

Multiple epidermolytic acanthomas mimicking condyloma : A retrospective study of 8 cases. / Lee, Tsung Ju; Wu, Yu Hung.

In: International Journal of Dermatology, Vol. 57, No. 1, 01.01.2018, p. 28-33.

Research output: Contribution to journalArticle

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abstract = "Background Epidermolytic acanthoma (EA) is an uncommon benign cutaneous lesion. Multiple epidermolytic acanthomas (multiple EAs) are rarely reported. Methods We retrospectively identified patients diagnosed with multiple EAs between 2005 and 2017 from our dermatopathology database and analyzed their clinical, pathological, and immunohistochemical features. We also evaluated the association of multiple EAs with human papillomavirus (HPV) infection. Results In total, eight patients (average age 51 years; 3: 1 male predominance) with multiple EAs were found. All patients had lesions on the genitocrural area. The two most common clinical diagnoses were condyloma (5/8) and soft fibroma (3/8), which were predominantly skin-colored (5/8) or whitish (2/8). The lesions were less than 1 cm in diameter, and most (6/8) appeared to have a smooth surface. No molecular evidence suggesting HPV infection was found. Immunohistochemical staining showed low mitotic activity. The lesions were removed in one of two patients via cryotherapy, and one patient was treated with electrocauterization. The other five patients were followed without treatment. Conclusion The genital area was the most common location for multiple EAs, which was commonly misdiagnosed clinically as condyloma. Patients presenting with uniformly small-sized, skin-colored to whitish, smooth papular lesions in the genitalia should be carefully evaluated. The specific pathological features of epidermolytic hyperkeratosis are diagnostic, and the lesions can be observed without aggressive treatment after confirmed diagnosis.",
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