We report the case of a 55-year-old male who presented with asymptomatic scrotal papules since 3-4 months. He had no comorbidities. Clinical differentials comprised genital verrucae and high-grade squamous intraepithelial lesion (previously called bowenoid papulosis). Skin biopsy findings comprised perinuclear vacuolization of the stratum spinosum and granulosum, reticular degeneration, and coarse keratohyaline granules. These features were suggestive of epidermolytic acanthoma. Surprisingly, DNA PCR was positive for HPV52, a high-risk HPV type, unlike previous case reports. Further research may be warranted on the pathogenesis, especially keratin 10 mutations and HPV positivity.
Vishwanath et al. (2026) studied this question.