reported a case in an immunosuppressed patient and suggested the role of decreased immune surveillance in the production of this lesion. Differential diagnoses to consider include acantholytic dermatoses such as pemphigus, Grover's disease, and Hailey-Hailey disease. These disorders are more extensive papular, vesicular, or papulovesicular eruptions. Acantholytic acanthoma can be differentiated from various acanthomas by the outstanding acantholysis. In focal acantholytic dyskeratosis and warty dyskeratoma, Darier-like alterations are more prominent; in epidermolytic acanthoma, epidermolytic hyperkeratosis are more prominent; in lichenoid keratosis, lichenoid hyperplasia; and in pale cell acanthoma, clear cell acanthosis. 1 Acantholytic acanthoma lacks the cellular dysplasia of acantholytic solar keratosis and the general configuration of an acantholytic seborrheic keratosis. 2 As acantholytic acanthoma is a benign solitary condition, simple excision is the treatment of choice.