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Multiple epidermolytic acanthomas mimicking condyloma: a retrospective study of 8 cases
Author(s) -
Lee TsungJu,
Wu YuHung
Publication year - 2018
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.13818
Subject(s) - medicine , epidermolytic hyperkeratosis , dermatopathology , cryotherapy , dermatology , pathological , pathology , lesion , retrospective cohort study , hyperkeratosis , radiology
Background Epidermolytic acanthoma ( EA ) is an uncommon benign cutaneous lesion. Multiple epidermolytic acanthomas (multiple EA s) are rarely reported. Methods We retrospectively identified patients diagnosed with multiple EA s between 2005 and 2017 from our dermatopathology database and analyzed their clinical, pathological, and immunohistochemical features. We also evaluated the association of multiple EA s with human papillomavirus (HPV) infection. Results In total, eight patients (average age 51 years; 3 : 1 male predominance) with multiple EA s 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 EA s, 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.