10.5826/dpc.1203a84
text/xml
2160-9381
1955
en
Ibrahim Kobat
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
domed papules
Dermoscopic View of Papular Acantholytic Dyskeratosis (PAD) of the Genitocrural Region
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2022-07-28
2021-08-13
2022-07-28
2022-09-15
e2022084
Dermatol Pract Concept
Ibrahim Kobat
2022/07/28
10.5826/dpc.1203a84
e2022084
Famagusta State Hospital Pathology Department, Famagusta, Cyprus
2160-9381
domed papules
en
e2022084
El Kadiri S, Bay Bay H, Chaoui R, Douhi Z, Elloudi S, Mernissi FZ. Dermoscopy of Hailey - Hailey disease: Is it useful? Our Dermatol Online. 2020;11(e):e50.1-e50.2.
Dermoscopic View of Papular Acantholytic Dyskeratosis (PAD) of the Genitocrural Region
https://dpcj.org/index.php/dpc/article/download/1955/1655
                    Dermatology Practical & Conceptual


             Dermoscopic View of Papular Acantholytic
              Dyskeratosis of the Genitocrural Region
                                       Dua Cebeci1, İlkay Can2, İbrahim Kobat3


1 Famagusta State Hospital Dermatology And Venerology Department, Famagusta, Cyprus
2 Balıkesir State Hospital Dermatology And Venerology Department, Balıkesir, Turkey
3 Famagusta State Hospital Pathology Department, Famagusta, Cyprus



Key words: acantholytic dyskeratosis, genital region, domed papules
Citation: Cebeci D, Can İ, Kobat İ. Dermoscopic view of papular Acantholytic Dyskeratosis (PAD) of the genitocrural region.
Dermatol Pract Concept. 2022;12(3):e2022084. DOI: https://doi.org/10.5826/dpc.1203a84
Accepted: October 21, 2021; Published: July 2022
Copyright: ©2022 Cebeci et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License
(BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/which permits unrestricted noncommercial use, distribution, and reproduction
in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Dua Cebeci, Famagusta Stat Hospital, Famagusta, Cyprus, Telephone number : 05488586367
E-mail : perolidua@gmail.com




Introduction                                                             condyloma. She had no history or family history of any skin
                                                                         disorder. Physical examination revealed multiple whitish
Papular acantholytic dyskeratosis (PAD), also known as ac-               pruritic papules with underlying erythematous patches in
antholytic dermatosis of the vulvocrural (or anogenital) re-             both inguinal regions (Figure 1A). No lesions were found
gion is a rare skin disorder reported more common in women               at other locations and her nails were normal. KOH test was
than men. Recent studies have revealed that mutations in the             negative. Skin biopsy showed numerous typical acantholy-
ATP2C1 gene, typically seen in Hailey-Hailey disease, are                tic dyskeratotic cells in the stratum corneum and spinosum.
also detected in papular acantholytic dermatosis of the ano-             There was also hyperkeratosis and irregular acanthosis in
genital region [1]. We report a case of a 49-year-old female             the epidermis and lymphocytic infiltration in the underlying
with pruritic papular eruptions over the vulvocrural area.               dermis and no evidence of viral infection, dysplasia or ma-
Histology of lesions revealed focal acantholysis with pres-              lignancy (Figure 2). Dermoscopic examination (×10 magni-
ence of dyskeratotic cells resembling corps ronds and grains.            fication in polarized mode) showed an irregular star-shaped
                                                                         (circled) brown pigmentation and globular domed brown
                                                                         papules (Figure 1B). Direct immunofluorescence or genetic
Case Presentation
                                                                         studies were not performed. Clinical and histopathological
A 49-year-old female patient presented with persistent pru-              PAD was present. 0.1% topical mometasone furoate and
ritic papular rash in both inguinal regions for 6 months. The            topical tacrolin 0.1 cream were started on the patient. The
patient applied to the obstetrics clinic with similar complaints         patient showed a minimal improvement and is still being fol-
and was referred to the dermatology clinic considering as                lowing up. Constent form was obtained from the patient.




Research Letter | Dermatol Pract Concept. 2022;12(3):e2022084                                                                         1
               Figure 1. (a) Multiple shiny whitish papules 2 mm to 3 mm in diameter in a cobblestone pattern on the
               medial aspect of the thigh, on the perineum, and in the perianal region. (b) Dermoscopic image showing
               brown pigmentation and globular domed brown papules.




               Figure 2. (a) Low-power view of a papule showing suprabasal cleft, dyskeratosis, and acantholytic cells
               (H&E, ×10). (b) High-power view of dyskeratotic acantholytic cells (corps ronds, H&E, ×40).



Conclusions                                                         dermoscopic findings. By reporting the dermoscopy of this
                                                                    case PAD, we would like to point out the usefulness of such
Localized PAD to the genitocrural area is a rare and distinct       dermoscopy in assisting the recognition of this entity.
clinical entity that was first described by Bernard Ackerman
in 1972 as focal acantholytic dyskeratosis.
    The dermoscopic features of Hailey-Hailey and Darier
                                                                    References
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moscopic features of the reported cases of PAD have not                 Huang C. Papular acantholytic dyskeratosis of the anogenital
been experienced. In Hailey-Hailey disease, the combination             and genitocrural area: case series and review of the literature.
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