Papular acantholytic dyskeratosis of the genitocrural area with positive direct immunofluorescence in a man affected by lichen sclerosus et atrophicus: a clinicopathological challenge.

Dear Editor, Papular acantholytic dyskeratosis (PAD) is a rare, sporadic, persistent disease of adulthood, localized to the genitocrural and anogenital regions. It was proposed as a new entity by Chorzelski et al. in 1984, based on the case of a 23-year-old woman with multiple, dome-shaped, white papules grouped on her vulva, which revealed histopathologically an epidermal proliferation with acantholysis and dyskeratosis, resembling both Haley-Haley (HHD) and Darier diseases (DD). Since then, PAD was reported as an asymptomatic/slightly itchy eruption of multiple white to skin-colored papules, coalescing to plaques, more commonly around the vulva. Cases among males were fewer. [...].