Pale cell acanthoma, an entity recently established by French investigator is characterized by a lesion, usually solitary, and commonly on the lower extremities of adults. The appearance is that of a round, reddish, elevated, occasionally bleeding, or crusted growth not larger than 20 mm, but often smaller. If untreated it has been known to remain for as long as 25 years. Treatment is surgical. Recurrences are unknown. The microscopic appearance is unique and reveals regular acanthosis with striking pale prickle cells, rich in glycogen, and edematous vascularized papillae. A sprinkling of various inflammatory cells in dermis and epidermis and parakeratosis are noted with regularity. A sharp border between normal and abnormal epidermis is typical. Six pertinent cases are recorded, 2 of which have been followed for 10 and 3 years respectively.