Localized epidermolytic hyperkeratosis of the female external genitalia.
BACKGROUND
Epidermolytic hyperkeratosis (EH) is most commonly associated with the diffuse involvement of congenital ichthyosiform erythroderma, but can also be found in a localized pattern. Localized EH is rare, but mucocutaneous lesions have been been identified, most commonly in the mouth.


METHODS
We observed a 58-year-old African-American female who noted spots on her genitalia for approximately 2 years. The lesions were increasing in size, darkening, and had become pruritic and sore over the past 6 months.


RESULTS
Physical examination revealed seven scattered, tan to brown, verrucoid papules on the labia and mons pubis, resembling condylomata acuminata or Bowenoid papulosis. Biopsy of a single labial papule revealed epidermal acanthosis, compact hyperkeratotic papillomatosis, perinuclear clear zones, granular keratohyalin clumping, hypergranulosis, and dyskeratosis resulting in intracellular eosinophilic globules, all characteristic of EH.


CONCLUSIONS
Because of the rarity of localized genital EH and similar appearance to common diagnoses, clinical confusion may occur without biopsy.
Swann
Michael H
MH
University of Arkansas for Medical Sciences, Dermatology, Little Rock, AR, USA.
Pujals
John S
JS
Pillow
Jessica
J
Collier
Susannah L
SL
Hiatt
Kim
K
Smoller
Bruce R
BR
D001706:Biopsy; D005260:Female; D005836:Genitalia, Female / Q000473:pathology*; D006801:Humans; D017488:Hyperkeratosis, Epidermolytic / Q000473:pathology*; D008875:Middle Aged