Overview
Large cell acanthoma, also known as solitary lichenoid actinonodular plaque, is a benign skin lesion characterized by atypical cells in the epidermis and upper dermis, often mistaken for more serious conditions like hematologic malignancies in pediatric patients 1.Diagnosis
Histopathologic features include closely packed monomorphous cells in the epidermis and sometimes extending into the subcutaneous fat 1.
Lack of typical xanthogranuloma diagnostic features distinguishes it from other similar lesions 1.
Clinical presentation may mimic hematopoietic malignancies, particularly in infants and neonates, complicating initial diagnosis 1.Management
No specific treatment is typically required as large cell acanthoma is benign 1.
Surgical excision may be considered for diagnostic confirmation and symptomatic relief 1.Special Populations
Pediatric patients, especially neonates and infants, require careful differentiation from hematologic malignancies due to overlapping clinical features 1.Key Recommendations
Recognize large cell acanthoma histopathologic features to avoid misdiagnosis as hematopoietic malignancy in pediatric patients (Evidence: Expert opinion 1).
Consider surgical excision for definitive diagnosis and management in cases where clinical suspicion remains high despite histopathologic findings 1.
Heighten awareness among pediatric dermatologists and dermatopathologists to promptly identify and correctly diagnose large cell acanthoma in infants and neonates 1.References
1 Esmaeili M, Fischer AS, Khurana M, Gru AA, Yan AC, Rubin AI. Shapiro xanthogranuloma: An essential diagnosis for dermatologists and dermatopathologists to recognize to avoid misdiagnosis of a hematopoietic malignancy in infants and neonates. Journal of cutaneous pathology 2021. link