Clear Cell Acanthoma Research Articles

Reflectance Confocal Microscopy and Dermoscopy for the Diagnosis of Solitary Hypopigmented Pink Lesions: A Narrative Review.

Diagnosing solitary pink skin lesions poses a significant challenge due to the scarcity of specific clinical and dermoscopic criteria. Several benign lesions, such as cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus, often exhibit similar clinical and dermoscopic features. This similarity extends to some malignant lesions, including basal cell carcinoma, actinic keratosis, and amelanotic melanoma, making differentiation difficult. Recent studies highlight the enhanced diagnostic accuracy of reflectance confocal microscopy (RCM), which offers increased sensitivity and specificity compared to dermoscopy alone for diagnosing skin cancer. This study aims to summarize the application of dermoscopy and RCM in distinguishing between benign and malignant pinkish-reddish skin lesions. The integration of RCM with traditional dermoscopic techniques improves the ability to accurately identify and differentiate these lesions. However, it is crucial to note that for any suspicious lesions, a final diagnosis must be confirmed through surgical excision and histopathological evaluation. This comprehensive approach ensures accurate diagnosis and appropriate treatment, highlighting the importance of combining advanced imaging techniques in clinical practice.

Human Papillomavirus-Associated Giant Clear Cell Acanthoma and Squamous Cell Carcinoma: A Rare Case Report and Literature Review.

Clear cell acanthoma (CCA) and squamous cell carcinoma (SCC) represent distinct entities within dermatological oncology, each posing unique diagnostic and therapeutic challenges. CCA is a rare, benign epidermal growth, often not associated with human papillomavirus (HPV) infection, whereas SCC, a more aggressive form of skin cancer, has been linked to both ultraviolet (UV) exposure and HPV. Understanding the co-occurrence of these conditions in a single patient can enhance diagnostic accuracy and therapeutic outcomes. We report a 64-year-old male who underwent an operation for a verruciform lesion in the right groin, which was diagnosed as HPV-positive CCA alongside keratinised SCC. A literature search across January 2024 revealed limited evidence directly linking HPV to CCA, suggesting a need for further investigation. The speculative association between HPV and CCA warrants deeper exploration, especially considering the potential for HPV to contribute to lesion development through indirect mechanisms. The coexistence of CCA and SCC in an elderly patient presents a unique clinical scenario. This emphasises the need for vigilant diagnosis and tailored treatment strategies, highlighting the gap in understanding the pathogenesis of CCA, particularly its potential association with HPV. Further research is crucial for elucidating the complex interactions governing these conditions and for developing targeted interventions.

Giant clear cell acanthoma: a case report and a review of the literature

Clear cell acanthoma (CCA) is an uncommon benign epidermal tumor of unknown origin and etiology. It is often solitary, and the presence of multiple CCAs in the same individual is rare. Typically, it presents as a slowly growing plaque or nodule located on the legs with a peripheral scaling collarette. Diagnosis is primarily based on clinical and histopathological findings, with dermoscopy enhancing diagnostic accuracy. The differential diagnosis includes various skin tumors and inflammatory dermatoses. The preferred treatment is surgical excision, as these lesions do not regress spontaneously. We describe a case of a large CCA on the right thigh associated with multiple small nodular lesions scattered across the legs.

Translated article] Clear Cell Acanthoma: A Series of 70 Cases

Background and objectiveClear cell acanthoma (CCA) is an uncommon lesion histologically characterized by the presence of epidermal acanthosis with keratinocytes containing clear cytoplasm. Although many single cases of CCA have been described, few case series have been published. The aim of this study was to describe the clinical characteristics of CCA in our practice setting. Material and methodsRetrospective study of patients diagnosed with CCA at Hospital Universitario de Bellvitge in Barcelona, Spain, between 1995 and 2021. We conducted a chart review to record age, sex, number and location of lesions, diameter, time since onset, clinical characteristics, suspected clinical diagnosis, and treatment. ResultsSeventy patients (30 women and 40 men) with a mean (SD) age of 62 (13) years were diagnosed with CCA during the study period. Median (interquartile range) time since onset was 2 (4) years and median lesion diameter was 6 (5)mm. One woman had multiple lesions. Lesions were located on the lower extremities in 57 patients (81%), the posterior aspect of the trunk in 8 (11%), the anterior aspect of the trunk in 4 (5%), and the upper extremities in 1 (1%). CCA was clinically suspected in 40% of patients seen by dermatologists. ConclusionsCCA presents as an erythematous, dome-shaped lesion with pinpoint vessels and an epidermal collarette. The accuracy of clinical diagnosis has improved relative to earlier series, possibly due to a better clinical understanding of this lesion and a greater use of dermoscopy.

Claudin-4 Expression in the Distinction of Mammary and Extramammary Paget Disease From Morphologic Mimics: Diagnostic Utility and Pitfalls.

Claudin-4 Expression in the Distinction of Mammary and Extramammary Paget Disease From Morphologic Mimics: Diagnostic Utility and Pitfalls.

Generalized eruptive clear cell acanthomas

AbstractIn most cases, clear cell acanthoma (CCA) is an uncommon solitary lesion with distinctive clinicopathological features. We report the case of an 80‐year‐old man with generalized asymptomatic skin lesions predominantly affecting his chest, abdomen and his legs. On dermoscopy, the lesions showed dotted vessels in a linear pearl‐like distribution (“pearl necklace”) surrounded by a slightly whitish halo. Histopathology clearly confirmed the diagnosis of CCA. In conclusion, CCA being an uncommon solitary skin lesion may also appear in very rare cases as a generalized eruptive skin condition.

Multiple disseminated clear-cell acanthomas associated with colon cancer: more than a mere coincidence?

Multiple disseminated clear-cell acanthomas associated with colon cancer: more than a mere coincidence?

Clear (Pale ) Cell Acanthoma

A 36-year-old gentleman presented to the Dermatology and Venereology outpatient clinic with a painless nodule of the volar aspect of the left forearm for six months (Panel A). On examination, there was a single, non-tender, smooth surface, and dome-shaped nodule. It was shiny with a reddish rim at its periphery. The nodule was excised completely as a treatment and for histopathological examination that shows it as a clear cell acanthoma (CCA) [panel B (H/E-4X) and C (H/E-10X)]. CCA is a rare benign cutaneous tumor of unknown cause. It is mostly presented as a painless, solitary, slowly growing, and pink-brown or red nodule that is seen mostly on the distal lower extremities of middle-aged and elderly patients. Multiple lesions and different morphologies such as polypoid, giant, atypical, pigmented, and cystic lesions can be seen. Other sites like the abdomen, areola, face, and scrotum can be affected. CCA has specific dermoscopic features in which the blood vessels are arranged in a string-like appearance, but the diagnosis is rarely done without biopsy. Histopathological examination reveals epidermal acanthosis with a psoriasiform pattern of pale keratinocytes and spongiosis in association with dilated blood vessels of the edematous dermal papillae. CCA is treated by surgery such as excision, CO2 laser, or cryosurgery. With a weekly regular follow-up of the patient for two months, the lesion was completely cured.

Hidden clear cell acanthoma with uncommon dermoscopic findings

Hidden clear cell acanthoma with uncommon dermoscopic findings

Clear Cell Acanthoma of the Mammary Region: A Case Report

Clear cell acanthoma, also known as Degos acanthoma, is a rare benign epithelial skin tumor. Generally, it appears as a solitary lesion on the lower legs, but in this case, it appeared on the right mammary area near the areola, which is an exceedingly rare and exciting finding. This lesion's clinical features revealed elevated dome-shaped plaque with surface lobulations and shiny pink color with a size of 9 mm. Dermoscopy was characteristic with blood vessels lined up in a strings pattern. Excision biopsy was done as a therapeutic measure. Histopathology showed a collection of glycogen-containing cells in the epidermis consistent with the diagnosis of clear cell acanthoma. Classical dermoscopy features and diagnostic histology were exemplary for a case report.

Therapeutic and diagnostic considerations in multiple eruptive clear cell acanthoma

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.

Clear cell acanthoma.

Clear cell acanthoma is a rarely diagnosed tumor with variable clinical morphology that is usually only recognized by its histopathological features. The primary lesion is a red papule a few millimeters in diameter that often occurs as a single lesion on the lower extremities. In dermoscopy, resemblance of the vessels to a string of pearls is a largely specific finding of clear cell acanthoma. In contrast to the initially uncharacteristic clinical findings, histopathology of clear cell acanthomas is characterized by a typical compact, well-demarcated acanthosis consisting of pale-staining, PAS-reactive keratinocytes. As etiology and pathogenesis are both unclear, nosology of clear cell acanthoma is also controversial, with an ongoing debate as to its classification as cutaneous neoplasia or reactive inflammatory dermatosis.

Clear Cell Acanthoma: A Review of Clinical and Histologic Variants.

Degos and Civatte first described clear cell acanthoma (CCA) in 1962 and later in a review article found that, in most instances, the lesion was a solitary red-brown dome-shaped papule that involved the distal lower extremity. The first morphologic variant of CCA was reported as a “giant form of the acanthoma of Degos” which measured 45 × 40 mm, about twice the size of the largest CCA documented earlier. Since then, many variants of CCA have been described, including polypoid, pigmented and atypical. Herein, we describe a new variant of CCA and add another example of the polypoid variant to the literature. The new variant exhibits cellular features of trichilemmoma but architecturally differs from it. We also attempt to broaden the list of CCA variants summarized by Tempark and Shwayder by adding ours and a few more examples of CCA. The new variants of CCA include verrucous, linear, subungual and trichilemmal.

Polarizing-specific white lines in a clear cell acanthoma

Polarizing-specific white lines in a clear cell acanthoma

The complexity of clear cell acanthoma diagnosis based on the literature review.

The complexity of clear cell acanthoma diagnosis based on the literature review.

Dermoscopic features of Clear Cell Acanthoma: A Case Report and Review of the Literature

Clear cell acanthoma is an uncommon type of benign epithelial tumor. Typically, it is a solitary lesion found on the lower limbs. It presents as a nodule or small plaque with slow and well-defined growth. Diagnosis used to be clinical and histopathological, but the advent of dermoscopy has led to an increase in diagnostic accuracy. We describe a case in which dermoscopy proved highly useful for diagnosis of the lesion.

Clarion and Crystal-Clear Cell Acanthoma Reviewed

Clear cell acanthoma was portrayed primarily by Degos [1]. Clear cell acanthoma is also referred to as Degos’ acanthoma or pale cell acanthoma and is cogitated as an asymptomatic, benign epidermal tumor devoid of gender predilection.

Pale (Clear) Cell Acanthoma of the Palate

Clear cell acanthoma (CCA), also known as pale cell acanthoma, represents a rare benign epidermal tumor with strong predilection for the lower extremities of middle-aged individuals and no frank gender preference. The etiology of CCA is poorly understood, although a localized psoriasiform reaction is favored. Herein, we report on the clinicopathologic and immunohistochemical features, and HPV status of an apparent example of oral CCA. A 58-year-old female presented with a well-circumscribed, asymptomatic, exophytic, sessile and erythematous nodule of the right hard palate, measuring 0.7cm in greatest dimension. Microscopically, the lesion featured parakeratosis and acanthosis with neutrophilic microabscesses and broad elongated rete pegs. In areas, spinous epithelial cells exhibited pale or clear cytoplasm without nuclear pleomorphism, mitoses or cytologic atypia. The supporting connective tissue revealed mild chronic inflammation with few scattered neutrophils and numerous capillary vessels. PAS histochemical stain with and without diastase disclosed the presence of cytoplasmic glycogen in the pale cells. The majority of glycogen-rich epithelial cells stained strongly for EMA and were negative for D2-40. Ki-67 immunostaining was confined only to the basal cell layer of the epithelium. A diagnosis of CCA was rendered. The lesion was negative for human papillomavirus (HPV) infection, as assessed by HPV-DNA PCR using the MY09/11 primers for the L1 conserved region, thus HPV infection does not appear to contribute to the pathogenesis of oral CCA. In conclusion, we report an intraoral example of CCA in order to raise awareness about this entity.

Clear cell acanthoma (CCA)-like lesions of the nipple/areola: A clinicopathological study of 12 cases supporting a nonneoplastic eczematous disease

Clear cell acanthoma (CCA) of the nipple/areola has been reported. The CCA-like histology more likely represents a feature of eczematous dermatitis of the nipple/areola. We reviewed cases of CCA-like lesions of the nipple/areola and compared them with classic CCA to clarify their relationship. The clinicopathological features of 12 cases of CCA-like lesions of the nipple/areola were compared with classic CCA. The literature on this condition was reviewed, and the results of various treatments were analyzed. CCA-like lesions of the nipple/areola were clinically different from those of classic CCA. Although they shared the glycogen-rich clear epidermal cells with neutrophilic exocytosis, dermal eosinophils appeared to be a distinctive feature. The anatomic site and association with atopic dermatitis suggested that CCA-like lesions of nipple/areola might represent a manifestation of atopic eczema involving nipple/areola. Topical steroids could be effective. This was a retrospective study with limited cases. Although CCA-like lesions of the nipple/areola shared histopathological features with classicCCA, their clinical changes were consistent with dermatitis. We propose to namethis condition CCA-like eczematous dermatitis of the nipple/areola.

Clear Cell Acanthoma on the Areola

Clear cell acanthoma (CCA) is a rare, benign cutaneous condition most often seen on the lower extremities. Lesions are of variable morphology and have been described as polypoid, pigmented, giant, and cystic lesions. Although no racial or gender predilection has been reported, CCA on the breast is a very rare finding that has been observed mainly in young Korean women. Herein, we describe a case of CCA of the areola in an elderly woman with metastatic renal cell carcinoma. Physical exam revealed a pink plaque with central erosions on the left areola. Given the concern for cutaneous metastasis, excisional biopsy was performed, which showed pale glycogenated epithelium consistent with CCA. No evidence of recurrence or new lesions was observed after 6 months of follow-up. Our case exemplifies that clinicians should consider CCA in the differential diagnosis for a new eczematous lesion involving the breast, even in the setting of malignancy.