Acanthomas, disseminated epidermolyticD23.L

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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DefinitionThis section has been translated automatically.

Benign, acquired, wart-like skin lesions that show the clinical picture of epidermolytic acanthomas and occur preferentially in light-exposed areas Fine-tissue granular degeneration of the epidermis.

EtiopathogenesisThis section has been translated automatically.

Obviously no viral genesis, UV light can induce lesions (e.g. after PUVA bath therapy or dermatitis solaris)

LocalizationThis section has been translated automatically.

Preferably on light-exposed skin of the upper back.

Clinical featuresThis section has been translated automatically.

Multiple, isolated standing, 3-5 mm large, skin-coloured, slightly brownish hyperkeratotic, verrucous papules. Partly agonizing itching.

HistologyThis section has been translated automatically.

  • Premature and defective keratinization of the keratinocytes. Intact stratum basale. The cells of the stratum spinosum and stratum granulosum are perinuclearly vacuolated, show pale eosinophilic cytoplasm and blurred cell boundaries. Overall widening of the stratum granulosum with many irregularly shaped keratohyalin-like granules. Orthohyperkeratosis overlying the lesions.
  • Electron microscopy: Clumped and thickened keratin/tonofilament aggregates perinuclear in the suprabasal keratinocytes. Enlarged keratohyalin granules. Intact desmosomes.

DiagnosisThis section has been translated automatically.

Histology.

Differential diagnosisThis section has been translated automatically.

Congenital cornification disorders (e.g. dyskeratosis follicularis), seborrheic warts (s. verruca seborrhoica), flat warts ( verrucae planae juveniles).

TherapyThis section has been translated automatically.

Local therapy with 0.1% tretinoin (e.g. Cordes VAS) and 0.025% fluocinolone acetonide ointment/cream (e.g. jellin ointment/cream) once/day for 4 weeks.

LiteratureThis section has been translated automatically.

  1. Metzler G et al (1997) Disseminated epidermolytic acanthomas. Dermatologist 48: 740-742
  2. Sanchez-Carpintero I et al (1999) Disseminated epidermolytic acanthoma probably related to trauma. Br J Dermatol 141: 728-730

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer