Clear cell papulosis: Report of three cases of a newly recognized disease

Abstract

Background: Clear cell papulosis is a newly described disease. Since the first report in 1987, no other cases have been reported. Objective: Our purpose was to describe three more newly identified cases that further characterize this disease. Methods: Formalin-fixed and paraffin-embedded biopsy specimens were used for histochemical and immunohistochemical studies. Results: The three patients included two boys and, for the first time, a girl. All three had multiple white papules on the lower part of the abdomen, with or without scattered lesions along the milk lines bilaterally. The main histopathologic finding was the presence of clear cells scattered mainly among the basal cells of the acanthotic epidermis. The clear cells were variably stained by mucicarmine, colloidal iron, alcian blue (pH 2.5), periodic acid-Schiff, the anticytokeratin antibody AE1, carcinoembryonic antigen, epithelial membrane antigen, and gross cystic disease fluid protein-15. Conclusion: Clear cell papulosis is a unique clinicopathologic entity. The clear cells were confirmed to be sweat gland secretory cells by their positive immunostaining with gross cystic disease fluid protein-15. The latter was also present in eccrine sweat gland coil cells. However, whether the clear cells were eccrine or apocrine secretory cells could not be determined.