Reticulated Acanthoma With Sebaceous Differentiation

Abstract

Reticulated acanthoma with sebaceous differentiation (RASD) is characterized by the reticulated proliferation of spinous cells with aggregates of mature sebocytes in the bases of the strands of the keratinocytes, often linking rete ridges. Here, we report the first case reported as RASD. A 55-year-old woman presented with a 15-year history of a slightly pruritic patch on the upper back, and the histology was typical for RASD. She had been bothered by a yellow discharge from the tumor. Skin tumors with sebaceous differentiation are occasionally associated with Muir-Torre syndrome. However, immunohistochemical staining for mutS homolog 2 (MSH-2) and mutL homolog 1 (MLH-1) showed positive staining within the nuclei of sebaceous cells and cells in the dermis. Therefore, it is most likely that the present case is not associated with Muir-Torre syndrome.

Development of Six Tumors in a Sebaceus Nevus of Jadassohn: Report of a Case

“…SESD is very closely related to reticulated acanthoma with sebaceus differentiation but is a distinct tumor. Reticulated acanthoma with sebaceous differentiation (RASD) is mainly characterized by proliferation of spinous cells, aggregates of mature sebocytes in the bottom of the strand of epithelium, bridging of the bases of the epithelium by those mature sebocytes and lack of pseudocysts and melanin granules 12,13. Utilizing features like sebaceous aggregates located only at the basal aspects without a reticulated pattern, our case was differentiated from RASD.…”

Reticulated acanthoma with sebaceous differentiation: another sebaceous neoplasm associated with Muir-Torre syndrome?

“…Since then, there has been much speculation about the exact relationship between RASD and MTS. In more recent case reports, Fukai and colleagues and Haake and colleagues, however, performed immunohistochemical staining only for MLH1 and MSH2 protein and concluded that their cases probably had no association with MTS …”

Reticulated acanthoma with apocrine differentiation

“…Reticulated acanthoma with sebaceous differentiation has been defined as a benign proliferation of both keratinocytes and sebocytes, in a reticulated configuration, with acanthosis together with clusters of sebocytes at the bases of rete ridges 2–5 . Apocrine tubular structures are not typically a feature of this entity.…”