A rare presentation of acantholytic dyskeratosis

We describe an elderly woman who presented with numerous papular, keratotic lesions on the scalp. Histology of a biopsy specimen revealed epidermal invaginations, with large keratotic plugs, at the sites of hair follicles. In addition, there was acantholytic epidermal cell separation at a suprabasal level, and a large number of corps ronds were present above the split. It is likely that this case represents a rare presentation of acantholytic dyskeratosis. The relationship to other conditions which show acantholysis and dyskeratosis histologically is discussed.