Large cell acanthoma: A benign lesion masquerading as malignant melanoma

We present the case of a 54-year-old woman with a clinically suspected malignant melanoma. Histology, however, revealed the unexpected diagnosis of large cell acanthoma. This is a benign epidermal neoplasm that is poorly understood and underreported in the literature. The clinical and dermoscopic appearance in our patient differs from previously reported cases. We draw attention to this heterogeneous lesion and encourage further investigation into its classification and distinguishing features, which may ultimately inform optimal management for patients.