Acantholysis or intraepidermal split formation is uncommon in extramammary Paget's disease, but it is so prominent in this case that villi are present. It should be noted that melanomas that have a lentiginous radial growth phase  may form splits, but those are subepidermal. Suprabasal splits are sometimes found in actinic keratoses, but the location (lack of sun damage) would exclude that possibility in this case.
 

	Composite medium power view. A few pagetoid cells are in the epidermis in the left one half of the picture. Formation of villi is seen in the right one third of the picture.
	Higher power view from the left side of the picture above. The atypical  cells are prominent in the lower epidermis.
	High power view of above. BL arrows point to the basal layer of the epidermis. There is a suggestion of split formation between the basal layer and the atypical cells. There is also acantholysis of the atypical cells.
	Medium power view of the right side of the first picture. Suprabasal and intraepidermal splits are present.
	High power view of above.

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