Pathology of Large Cell Acanthoma - Dr Sampurna Roy MD

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Pathology of Large Cell Acanthoma

Large cell acanthoma usually presents as a well demarcated solitary plaque or scaly, lightly pigmented patch on sun exposed skin.

HPV type 6 is considered an important cofactor in the pathogenesis of large-cell acanthomas.

Site: Usually located on the face, or on the limbs and trunk.

Microscopic features:

Histopathological examination reveals sharp demarcation of the lesion from the normal epidermis.

The thickened epidermis consists of enlarged keratinocytes, twice the normal size.

Other features include basket weave orthokeratosis, prominent hypergranulosis and hyperpigmentation of basal layer.

In the dermis telangiectasia, solar elastosis and chronic inflammation may be present.

Differential diagnosis includes solar lentigo and solar keratosis.

(In solar keratosis there is parakeratosis, in large cell acanthoma there is orthokeratosis)