Papular acantholytic dyskeratosis of the genitocrural area: A rare unilateral asymptomatic intertrigo

Fig 1. Papular acantholytic dyskeratosis. Red-pink verrucous papules in a linear distribution. CASE REPORT A 78-year-old man was hospitalized for resection of a craniopharyngioma. His postoperative course was complicated by infections and a 4-month-long hospitalization. The dermatology department was consulted because of a new inguinal rash. The patient noted a 7-day history of a nonpruritic, nontender eruption localized to the right inguinal fold, treated with miconazole powder without improvement. He denied a history of similar eruption in the past. The patient denied family members with skin disease. Physical examination of the right inguinal fold found 15 to 20 pink-white verrucous papules in a linear, nonblaschkoid distribution (Figs 1 and 2). There was no involvement of the left crural fold, genitalia, or other areas of the body. His hands and feet were free of papules, and nail examination was negative for longitudinal erythronychia. A 3-mm punch biopsy was performed to clarify the diagnosis. Histologic examination found suprabasilar acantholysis and dyskeratosis, including the presence of corps ronds and grains, parakeratosis, and hyperkeratosis (Fig 3). There was no evidence of herpetic infection. Given the focal nature of these papules, a diagnosis of papular acantholytic dyskeratosis was made.