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8/8/2019 Benign Epidermal Tumors
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Benign epidermal tumorsBenign epidermal tumors
Deba P Sarma, MDDeba P Sarma, MD
OmahaOmaha
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EpidermisEpidermis
1. Basket-weave keratin
2. Granular keratinocytes
3. Maturing keratinocytes
4. Cuboidal basal cells with melanocytes
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Benign tumors from epidermalBenign tumors from epidermalcells(Keratinocytes)cells(Keratinocytes)
Epidermal nevusEpidermal nevus
AcanthomaAcanthoma
a. Seborrheic keratosisa. Seborrheic keratosis
b. Large cell acanthomab. Large cell acanthomac. Clear cell acanthomac. Clear cell acanthoma
d. Acantholytic acanthomad. Acantholytic acanthoma
e. Epidermolytic acanthomae. Epidermolytic acanthoma
f. Warty dyskeratomaf. Warty dyskeratoma
g. Pseudoepitheliomatous epidermal hyperplasiag. Pseudoepitheliomatous epidermal hyperplasia
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Epidermal nevusEpidermal nevus
Clinical:
-Verrucous papule at birth, early childhood.
-Solitary, clustered or linear on the trunk.
Pathology:
-Hyperkeratosis, acanthosis, papillomatosis.
-Regular church-spired or flat topped
(mesa)
papillomatosis.
-Rarely, acantholysis and dyskeratosis.
Church-spireMesa
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AcanthomaAcanthoma
Benign neoplasm of the acanthocytes (keratinocytes)Benign neoplasm of the acanthocytes (keratinocytes)
Acanthocytes + oma = AcanthomaAcanthocytes + oma = Acanthoma
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Seborrheic keratosisSeborrheic keratosis
Clinical:
Rough-surfaced papule, nodule, or plaque.
Common lesion after 40, any part of the body except palm and sole.Pathology:
Stuck-on, sharply demarcated raised lesion with a straight line at base.
Hyperkeratosis, acanthosis, papillomatosis, basaloid epidermal cells, pseudohorn
cysts with keratin.
Variations:Acanthotic, hyperkeratotic, reticulated, pigmented, clonal, irritated, and
inverted follicular keratosis.
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Large cell acanthomaLarge cell acanthoma
Clinical: Middle aged or older adults.
-Sharply demarcated patch on head and neck, trunk and limbs.
Pathology:
-Basket-weave hyperkeratosis, hypergranulosis, flat-topped papillomatosis and rounded
acanthosis.
-The keratinocyres of the lesion are larger with larger nuclei compared to
the adjacent epidermis.
-The lesion is sharply demarcated from the adjacent epidermis.
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Clear cell acanthoma (Pale cell acanthoma)Clear cell acanthoma (Pale cell acanthoma)
Clinical:Adults,> 40, leg
Pathology:
-Acanthotic epidermis is sharply demarcated from adjacent epidermis
-Composed of pale or clear keratinocytes with focal neutrophils (inset)
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