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Reticulated acanthoma with sebaceous differentiation: A case report
Wan-Ting Yu1, Qian Zhang, Hong Shen
1Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
Rationale:
Reticulated acanthoma with sebaceous differentiation (RASD) is a rare and benign cutaneous neoplasm that is characterized by reticulated epidermal hyperplasia and differentiation of mature sebaceous cells. Due to the scarcity of this condition, the potential association with Muir-Torre syndrome (MTS) remains the subject of debate.
Patient Concerns:
A 52-year-old Chinese woman presented with a 3-year history of a solitary papule on the right buttock.
Diagnoses:
Histopathology provided a confirmed diagnosis of RASD. Immunohistochemical analysis demonstrated uniform nuclear positivity for DNA mismatch repair proteins (MLH1, MSH2, MSH6, and PMS2). The absence of visceral malignancies and a negative family history, combined with the immunohistochemical results, provided no evidence for an association with MTS.
Interventions:
The lesion was completely excised with negative margins.
Outcomes:
No tumor recurrence was observed during 20 months of follow-up.
Lessons:
This rare case highlights the critical role of histopathological examination. Given the limited body of documented evidence for an association between RASD and MTS, documented, albeit limited, baseline immunohistochemistry and colonoscopy should always be considered to rule out MTS in patients diagnosed with RASD.
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