Large-cell acanthoma of the eyelid. Report of two cases

We describe two cases of large-cell acanthoma that involved the skin of the upper eyelid. Patient 1 was a 71-year-old white man with a pale, well-demarcated papillomatous plaque of 3 months' duration. Patient 2 was a 62-year-old white man with a sharply demarcated plaque-like thickening of the pretarsal skin involving the eyelid margin of 2 years' duration. In both cases, the histopathologic findings were similar and showed an abrupt transition at the edge of the lesion between the normal epidermis and the acanthotic plaque, which displayed hyperkeratosis, hypergranulosis, and focal parakeratosis. The localized epidermal thickening showed enlarged keratocytes that appeared twice their normal size. To our knowledge, this is the first report of large-cell acanthoma involving the eyelid.