Isolated epidermolytic acanthoma was first described in 1970 by Shapiro and Baraf1 as an acquired, solitary lesion showing features of epidermolytic hyperkeratosis (EH). They reported 7 cases, 6 having single and 1 having multiple lesions. The lesions were located on the anal region, calf, scrotum, leg, upper eyelid, and cheek. Clinically, the lesions of IEA are not diagnostic, and may resemble molluscum contagiosum, soft fibroma, carcinoma, and verrucae. In our case, the initial clinical findings suggested a solar keratosis, which persisted despite treatment with cryosurgery. Subsequently, the lesion became more like a prurigo nodule.
Persistent, Solitary, Erythematous, Hyperkeratotic Plaque. Arch Dermatol. 1998;134(4):499-504. doi: