Abstract

The clinical differential diagnosis for genital lesions is broad, including both viral and neoplastic entities. Amongst this differential is epidermolytic acanthoma (EA), which is a benign epidermal neoplasm that histologically exhibits epidermolytic hyperkeratosis, a histopathologic pattern consisting of hyperkeratosis, vacuolar degeneration of the suprabasilar epidermis, and intracellular eosinophilic globules. EA may present as a solitary lesion or as multiple lesions in the genital area. Often, these lesions are clinically misdiagnosed, resulting in patients undergoing unnecessary counseling and treatment. Here, we briefly describe the cases of three patients, one of whom underwent vulvar excision for suspected vulvar dysplasia, histologically diagnosed with genital EA. Through this case series, we emphasize the importance of biopsy and histopathologic evaluation of genital lesions when clinical diagnosis is unclear to ensure appropriate management.