Therapeutic and diagnostic considerations in multiple eruptive clear cell acanthoma

Abstract

Clear cell acanthoma represent a benign solitary epidermal tumor of the clear glycogen containing epithelial cells, which is quite common in dermatologic practice. The etiology of this tumor formation is not known exactly at the moment. Clinically, the lesion appears as a single reddish papule or papule-nodule and the characteristic of this lesion is represented by a peripheral scaling collarette. Although solitary lesions represent the most common form of presentation of the acanthoma with clear cells, less than thirtieth cases of multiple clear cell acanthoma, from two up to four hundred lesions, have been described in the medical literature to date. The diagnosis based on clinical features frequently needs to be supported using a dermoscopy exam and, in most cases, a histopathology exam is required. The treatment consists is complete removal (standard surgical excision, cryotherapy, electrofulguration alone, carbon dioxide laser or shave removal or curettage followed by electrofulguration). For the cases with multiple lesions, cryotherapy, or topical 5- fluorouracil are preferred. We present the case of a 62-year-old male patient, presented to our Dermatology Department for multiple asymptomatic rounded papules and multiple exophytic nodular tumor formations (approximate fifteen), on the lower extremities, which had occurred approximately two years previously and gradually increased in number.