Acanthoma - Types, Causes, Symptoms, Diagnosis, and Treatment

Introduction

Acanthomas are benign tumors present on the epidermis stratum skin. Keratinocytes are the cells on the basal and are almost seen in all four layers. Keratinocytes are the cells on the basal and are almost seen in all four layers. Acanthomas are usually present with keratinization. Acanthoma is a solitary lesion, and it is asymptomatic.

What Are Acanthomas?

Acanthomas are the small red bumps seen on the skin of older adults. Acanthomas are formed due to abnormal keratinization in the epidermis. Acanthomas are rare and benign skin tumors. Acanthomas have no gender preference, and it is observed that acanthomas are most commonly found in older adults due to aging. Many types of acanthoma are present. Acanthomas are usually asymptomatic, and no specific treatment is required for treating acanthomas. Surgical management is done to maintain the cosmesis of the patient.

The various forms of acanthomas are described below.

• Epidermolytic acanthoma.

• Seborrheic keratosis.

• Warty dyskeratoma.

• Acantholytic acanthoma.

• Dermatosis papulosa nigra.

• Melanoacanthoma.

• Clear cell acanthoma.

• Clear cell papulosis.

• Large cell acanthoma.

Epidermolytic Acanthoma:

Epidermolytic acanthoma form is more uncommon and is characterized as a solitary lesion. Sometimes epidermolytic acanthoma resembles a wart. Epidermolytic hyperkeratosis is the histopathological finding of epidermolytic acanthoma.

Seborrheic Keratosis:

Seborrheic keratosis is also called senile warts and basal cell papilloma. Seborrheic keratosis is common, and it is mostly present in middle-aged people. Seborrheic keratosis is characterized as a slightly raised lesion of gray to brown color. Seborrheic keratosis lesions are present in any body region, including the waistline, forehead, and chest. One of the rare features of seborrheic keratosis is the eczematous halo. Seborrheic keratosis can occur as an aging disorder. Treatment management of seborrheic keratosis is curettage, cautery, and cryotherapy.

Warty Dyskeratoma:

Warty dyskeratoma is a rare solitary lesion characterized by papulonodular lesions most commonly observed in the forehead and neck region. Warty dyskeratoma is most commonly observed in middle-aged and older people. The histopathological findings include acantholysis, dyskeratosis, and the keratin plug is also observed.

Acantholytic Acanthoma:

Acantholytic acanthoma is a single tumor mostly present in the trunk. Acantholytic acanthoma is more susceptible in older people. Acantholytic acanthoma is an asymptomatic condition, and the differential diagnosis of acantholytic acanthoma is the molluscum contagiosum. Sometimes, in addition to the solitary lesion, multiple lesions are also in acantholytic acanthoma.

Dermatosis Papulosa Nigra:

Dermatosis papulosa nigra is more commonly present in females when compared to males. The etiology of the incidence of dermatosis papulosa nigra is familial. The commonly involved site of dermatosis papulosa nigra is the neck, trunk, and malar region of the face. The disorder associated with dermatosis papulosa nigra is colon adenocarcinoma. The stratum basale layer of the epidermis shows hyperpigmentation.

Melanoacanthoma:

Melanoacanthoma is the variant of acanthoma described in 1960. Melanoacanthoma is a rare benign skin tumor. The abnormal function of melanocytes and keratinocytes causes melanoacanthoma. The differential diagnosis of melanoacanthoma is seborrheic keratosis. The clinical symptoms of melanoacanthoma resemble melanoacanthoma.

Clear-cell Acanthoma:

Clear-cell acanthoma is also called pale-cell acanthoma. It is an uncommon tumor, and it is observed in younger patients. The clinical feature of clear cell acanthoma is the dome-shaped plaque or nodule of pink to brown color. Both females and males are affected by clear-cell acanthoma. The diagnostic tool for clear cell acanthoma is the skin biopsy and the dermatoscopy. Excision of the tumor is the treatment done for clear cell acanthoma.

Clear-cell Papulosis:

Clear-cell papulosis is a variant of acanthoma, a rare condition. Clear cell papulosis is characterized as multiple papules. The most common sites are the face, abdomen, chest, and spinal region. Scattered clear cells are observed in the stratum basale layer of the epidermis.

Large-cell Acanthoma:

Large-cell acanthoma is the acanthoma variant induced by the sun. Large cell acanthoma is commonly observed in middle-aged people. Histopathological findings include the thick epidermis, orthokeratosis, and pigments in the stratum basale layer. The lesions are sharply demarcated from the normal keratinocytes. Inflammatory infiltration is present.

What Do Acanthomas Look Like?

Acanthomas are the small red bumps present on the skin of older people. Sometimes acanthoma is a solitary lesion. Multiple red bumps are observed in some cases.

The symptoms of acanthomas and their variants are mentioned below.

• Red solitary bump.

• Solitary or multiple lesions.

• Asymptomatic.

• The color of the lesion varies from red and brownish-red.

• Dome-shaped papules.

• Nodules are present.

• The size of the benign tumor ranges from millimeters to 2 centimeters.

What Are the Causes of Acanthomas?

The exact etiology of acanthomas is unknown. It is most prevalent among older people; the aging factor might be an etiology of acanthomas. Some of the variants of acanthomas are familial types.

The possible etiology of acanthomas is listed below.

• Age of the individual.

• Genetical factor.

• Sun-induced factor.

• Abnormal keratinization.

• Neoplastic condition.

• Idiopathic factor.

What Is the Diagnosis of Acanthomas?

Acanthomas are an asymptomatic condition. Physical examination of the clinical features is made to diagnose the acanthomas condition. The skin biopsy is taken, and the histopathological findings will be helpful in the evaluation of a particular variant of acanthomas.

The diagnosis of acanthoma is mentioned below.

• Physical examination.

• Dermatoscopy.

• Skin biopsy.

Histopathological findings of acanthomas are included in the following points.

• Abnormal keratinization.

• Hyperkeratosis is an increased deposition of keratin.

• Dyskeratosis.

• Acantholysis is present in warty dyskeratoma.

• Inflammatory infiltration.

• Electron microscopy.

What Is the Treatment of Acanthomas?

Acanthomas is an asymptomatic condition and does not require any treatment. The treatment is mainly done to maintain the cosmesis of the patient. The treatment methods for acanthomas are mentioned below.

• Shave excision of the tumor.

• Curettage.

• Cautery.

• Cryotherapy.

• In excisional surgery, the tumor is excised and sutured.

• Topical Tazarotene cream of 0.1% can be applied before cryotherapy.

Conclusion

Acanthomas are rare benign tumors of the skin's epidermis. The exact etiology of acanthoma is unknown and is predominant among older people. Acanthomas are an asymptomatic condition characterized by a small red bump on the face, trunk, and body parts. There are many variants of acanthomas. An individual can present with a single acanthoma or with an addition of another form of acanthoma. For cosmetic concerns, acanthoma is treated. Excision of the tumor can be done to maintain the cosmesis. However, acanthoma is not a fatal condition.