Achromic verrucous large cell acanthoma

Large cell acanthoma (LCA) is an epidermal neoplasm whose nature has been variously explained. Though frequently hyperpigmented, we describe for the first time an achromic case located on the dorsum of the right hand of a 83-year-old woman. This observation is largely inconsistent with one of the theories about the nature of this condition: that it is merely a solar lentigo with large nuclei of keratinocytes.