Byun Hyun Jeong, Jang Donghwi, Lee Jongeun, Oh Se Jin, Park Ji-Hye, Lee Dong-Youn
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Dermatol. 2020 Dec;32(6):512-515. doi: 10.5021/ad.2020.32.6.512. Epub 2020 Nov 11.
Epidermolytic acanthoma (EA) is a rare benign tumor, which usually appears as a solitary small papule. However, there are a few case reports of multiple EA, most of which occurs on the genital area. Cases of multiple EA may mimic verruca vulgaris, condyloma accuminatum, seborrheic keratosis, and bowenoid papulosis, and therefore, can be easily misdiagnosed. A 78-year-old male presented with a 2-week history of discrete, small skin-colored papules around the anus. The other case involved a 47-year-old male with a 5-year history of skin-colored papules on the scrotum. Skin biopsy of both cases revealed a well-demarcated papular lesion characterized by compact hyperkeratosis, perinuclear vacuolization, and reticular degeneration in the granular and upper spinous layer with coarse basophilic keratohyalin granules. Epidermal invagination was consistent with a cup-shaped type of EA. Both cases tested negative for human papillomavirus. We report typical cases of multiple EA, which should be considered as the differential diagnosis of small skin-colored papules in the anogenital area, to prevent the misdiagnosis.
表皮松解性棘皮瘤（EA）是一种罕见的良性肿瘤，通常表现为单个小丘疹。然而，有少数关于多发性EA的病例报告，其中大多数发生在生殖器区域。多发性EA病例可能会模仿寻常疣、尖锐湿疣、脂溢性角化病和鲍温样丘疹病，因此很容易被误诊。一名78岁男性，有2周肛门周围散在小肤色丘疹的病史。另一例是一名47岁男性，阴囊有5年肤色丘疹病史。两例皮肤活检均显示界限清楚的丘疹性病变，其特征为致密性角化过度、核周空泡化以及颗粒层和上棘层的网状变性，伴有粗大嗜碱性透明角质颗粒。表皮内陷符合杯状EA类型。两例人乳头瘤病毒检测均为阴性。我们报告了多发性EA的典型病例，应将其作为肛门生殖器区域小肤色丘疹的鉴别诊断考虑，以防止误诊。
