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A 48-year-old woman with fair skin presents for evaluation of a growth on the middle of her chest. She first noted the lesion approximately 3 months ago, and it has remained asymptomatic. Despite having a basal carcinoma removed from her temple at age 44 and undergoing treatment for actinic keratoses several times, she admits to ample sun exposure with only intermittent use of sunscreen.
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Acantholytic dyskeratotic acanthoma, an uncommon finding, was first described in a case report 12 years ago.1 As the name implies, on histologic evaluation, the neoplasm demonstrates both acantholysis and dyskeratosis similar to that of Darier disease, Grover disease, Hailey-Hailey disease, and warty dyskeratoma.
The majority of cases occur in middle-aged to elderly women. Lesions usually present as a solitary hyperkeratotic plaque located on the trunk or extremities.2 Acantholytic dyskeratotic acanthomas have been reported in immunocompromised individuals as well as in patients receiving vemurafenib.3-5 Lesions are benign; to date, no malignant transformations have been reported.
Stephen Schleicher, MD, is director of the DermDox Center for Dermatology, as well as an associate professor of medicine at Commonwealth Medical College and a clinical instructor of dermatology at Arcadia University and Kings College.
References
1. Omulecki A, Lesiak A, Narbutt J, Woźniacka A, Piekarski J, Biernat W. Plaque form of warty dyskeratoma – acantholytic dyskeratotic acanthoma. J Cutan Pathol. 2017;34(6):494-496
2. Goldberg A, Lee RA, Cohen PR. Acantholytic dyskeratotic acanthoma: case report and review of the literature. Dermatol Pract Concept. 2014;4(3):25-30
3. Ramos-Caro FA, Sexton FM, Browder JF, Flowers FP. Acantholytic acanthomas in an immunosuppressed patient. J Am Acad Dermatol. 1992;27(3):452-453.
4. Kanitakis J, Gouillon L, Jullien D, Ducroux E. Multiple acantholytic dyskeratotic acanthomas in a liver-transplant recipient. Dermatol Online J. 2019;25(4). Apr 15;25(4).
5. Komori T, Otsuka A, Kaku Y, Honda T, Kabashima K. Acantholytic dyskeratotic acanthoma: a possible skin adverse event of vemurafenib treatment. J Eur Acad Dermatol Venereol. 2017;31(10):e474-475.
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