Skin - Nonmelanocytic tumors
Benign (nonmelanotic) epidermal tumors or tumor-like lesions
Large cell acanthoma

Author: Hillary Elwood, M.D. (see Authors page)

Revised: 3 October 2016, last major update July 2015

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Large cell acanthoma [title] skin

Cite this page: Large cell acanthoma. website. Accessed October 28th, 2016.
Definition / General
  • Benign intraepidermal lesion composed of large keratinocytes
  • Debate as to whether this represents a distinct entity or a reaction pattern within a solar lentigo (Int J Dermatol 2003;42:36)
  • Recent study suggests large cell acanthoma is a solar lentigo with cellular hypertrophy (J Cutan Pathol 2014;41:733)
Case Reports
Gross Description
  • Light-tan to dark brown, well circumscribed macule or patch
  • Few millimeters to centimeters in diameter
  • Typically on sun exposed skin
  • Clinically resembles a seborrheic or actinic keratosis
Micro Description
  • Atrophic or acanthotic epidermis containing larger than usual keratinocytes (~2x normal epidermal keratinocytes)
  • Usually well demarcated from adjacent epidermis
  • Basal layer may appear hyperpigmented; sometimes conspicuous rete ridges
  • Orthokeratosis; may have hypergranulosis
  • Minimal nuclear pleomorphism
  • Basal mitoses only
Micro Images

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Large keratinocytes, hyperkeratosis

Differential Diagnosis