Eczematoid clear cell acanthoma of the nipple/areola: the first case reported in China and literature analysis / 中华皮肤科杂志

Objective:To investigate clinical manifestations, pathological features and diagnosis of eczematoid clear cell acanthoma of the nipple/areola.Methods:The clinical manifestations, histopathological features, special staining results and immunohistochemical features of a case of eczemtoid clear cell acanthoma of the nipple/areola firstly reported in China were analyzed, and compared with those of similar cases in foreign literature.Results:The female patient presented with recurrent pruritic rashes on the left nipple and areola for over 2 years. Skin examination showed hypertrophic skin on the left nipple and areola, and scattered erythema, hypopigmented macules and hyperpigmented macules on the areola, which were covered with a few crusts and scales. Histopathological examination of the skin lesions showed focal epidermal crusts and scales, focal parakeratosis, extended and fused rete ridges, thickened spinous layer, focal spongiosis, clear cell clumps in the spinous cell layer, telangiectasia in the superficial dermis, with infiltration of a few eosinophils and neutrophils. Periodic acid-Schiff staining showed positive results, and immunohistochemical staining revealed positive reaction for epithelial membrane antigen. Topical treatment with triamcinolone acetonide and econazole cream was effective, and topical application of 3% boric acid solution could alleviate exudation. During the 6-month follow-up, the patient experienced intermittent recurrence twice, and responded well to the above treatment.Conclusions:Eczematoid clear cell acanthoma of the nipple/areola has unique clinical and pathological features, revealing that it′s a new subtype of clear cell acanthoma. Pathological examination is the gold standard for its diagnosis.

Clinicopathological analysis of 10 cases of clear cell acanthoma / 中华皮肤科杂志

Objective To investigate clinicopathological features and differential diagnosis of clear cell acan?thoma (CCA). Methods Clinical and pathological data on 10 patients with CCA were retrospectively reviewed. Results CCA clinically manifested as widespread, well?circumscribed, hemispherical dark red to brown papules and nodules with ulcerative, hemorrhagic or desquamative surfaces. Most patients had no subjective symptoms. Nine patients had solitary lesions, and 1 patient had multiple lesions. It frequently occurred in the middle?aged or elderly. Histopathological examination showed thickened prickle cell layer, and the tumor was composed of large clear cells with pale?staining cytoplasm. Characteristic pathological findings were scattered neutrophils and nuclear dust in the epidermis. Periodic acid?Schiff (PAS) staining without diastase was positive in all the 10 patients. Immunohisto?chemical study revealed that tumor cells expressed epithelial membrane antigen (EMA) and keratin, but did not express carcinoembryonic antigen (CEA). Conclusions CCA has no obvious clinical characteristics, and is easily misdiagnosed as melanocytic or vascular tumors. However, CCA has typical histological changes, and histopathological examination is the gold standard for its diagnosis.

Clear cell acanthoma on areola / 영남의대학술지

Clear cell acanthoma (CCA) is an asymptomatic benign lesion of unknown origin that typically appears as a brownish, dome-shaped papule on the leg. It has an unusual clinical feature in that it appears as chronic eczema, Bowen disease, or Paget disease on the areola. Its histopathologic findings are well-demarcated psoriasiform acanthosis with pale keratinocytes (clear cells) that are rich in intracellular glycogen, which stain positively with Periodic acid-Shiff. We report herein on a young female patient with CCA on the areolar areas.

Clear Cell Acanthoma Clinically Presenting as an Erosive Nodule / 대한피부과학회지

No abstract available.

A Case of Polypoid Clear Cell Acanthoma on the Nipple

Clear cell acanthoma (CCA) is a rare benign epidermal tumor. It usually presents as a flat nodule or dome-shaped plaque and is often localized on the legs of the elderly. We observed an unusual case of polypoid CCA on the nipple of a 14-year-old girl. At present, a few cases of CCA on the nipple area have been reported in the literature. However, CCA presented as a polypoid tumor on the nipple area has been reported very rarely. We herein report the very rare case of polypoid CCA on the nipple and suggest that CCA should be included in the clinical differential diagnosis of polypoid lesions on the nipple.

The Expressions of Cytokeratin 16, Involucrin and PCNA in Clear Cell Acanthoma on Areola / 대한피부과학회지

BACKGROUND: Clear cell acanthoma usually appears as an asymptomatic nodule on the leg. It has an unusual clinical feature in that it is presented as chronic eczema on the areola. The origin of clear cell acanthoma is not yet clear, although many hypotheses have been proposed, including a benign neoplasm or an inflammatory dermatosis. OBJECTIVE: In this study, clear cell acanthoma on the areola showing clinically eczematous features were analysed by immunohistochemical techniques, using antibodies against cytokeratin 16, involucrin and PCNA and compared with psoriasis and squamous cell carcinoma. METHODS: Using the immunohistochemical method with formalin-fixed, paraffin-embedded sections, we analysed the expression of cytokeratin 16, involucrin and PCNA in biopsy specimens of 6 cases of clear cell acanthoma on the areola, 5 cases of psoriasis, and 5 cases of squamous cell carcinoma. RESULTS: The expression of cytokeratin 16 was detected in spinous and granular layers in all cases of clear cell acanthoma and psoriasis and three cases of squamous cell carcinoma. Psoriasis showed slightly higher immunoreactivity than clear cell acanthoma and squamous cell carcinoma, but this difference was not statistically significant (p=0.142). The expression of involucrin was detected in spinous and granular layers in all cases of clear cell acanthoma, psoriasis, and squamous cell carcinoma. The immunoreactivities were similar. The expression of PCNA was detected in basal and spinous layers in two cases of clear cell acanthoma, four cases of psoriasis, and five cases of squamous cell carcinoma. The expression of PCNA was higher in psoriasis and squamous cell carcinoma than in clear cell acanthoma, and this difference was statistically significant (p=0.034, p=0.004). CONCLUSION: Clear cell acanthoma on the areola may result from increased psoriasis-like inflammatory proliferation and accelerated differentiation of keratinocytes.

A Case of Clear Cell Acanthoma on the Dorsal Foot / 대한피부과학회지

Clear cell acanthoma is a rare, benign tumor of epidermal origin, with distinct histolopathological features which usually includes solitary or rarely multiple tumors, often localized on the lower legs of middle-aged or elderly people. It presents as a flat or dome-shaped, sharply-demarcated papule or nodule, sometimes with a keratotic scale of bright red or pink color. Histopathological findings include clear cells within sharply-demarcated area of the epidermis. We report a case of clear cell acanthoma which developed on the lateral side of the right foot of an 82-year-old man.

A Case of Pigmented Clear Cell Acanthoma / 대한피부과학회지

Clear cell acanthoma is a rare, benign, epidermal tumor. These tumors usually present as solitary lesions, often localized on the lower legs of middle aged or elderly individuals. Pigmented clear cell acanthoma, a variant of clear cell acanthoma, presents as macroscopically visible brown to black-colored, flat or dome-shaped, sharply-dermacated papules or nodules. Histopathologic findings in these tumors reveal markedly epidermal hyperplasia, with exception of the cells in the basal layer. Also, most of the epithelium showed pallor and slight enlargement. With these pigmented type tumors, dermal melanophages are often noticeable on low-power magnification, plus increased melanocytes with melanin granules in the epidermis. A 41-year-old man presented with a 7-year history of a 1.2x0.8cm sized, black plaque on the right inner thigh. The histologic findings revealed the typical features of pigmented clear cell acanthoma.

A Case of Pigmented Clear Cell Acanthoma

No abstract available.

Three Cases of Clear Cell Acanthoma on Nipple and Areola / 대한피부과학회지

Clear cell acanthoma is a relatively uncommon benign disease, which usually presents as solitary lesions, often localized on the lower legs of middle aged or elderly individuals1. Clinically it presents as a flat or dome-shaped, sharply demarcated papule or nodule. Histopathologic findings are composed of clear cells within sharply demarcated area of the epidermis. We report three cases of clear cell acanthoma developed on the nipples and areolar areas of the young women. These cases should be differentiated from various diseases showing clinically benign eczematous feature. In conclusion, clear cell acanthoma could be included in the differential diagnosis of eczema, and it is suggested that biopsies specimen should include the lesion as well as the normal tissue.

A Case of Clear Cell Acanthoma / 대한피부과학회지

Clear cell acanthoma has been described clinically as a well circumscribed round 1-2cm sized pink to brown colored solitary nodule or plaque. It develops slowly and affects people aged 40-60 years, and the lower legs are the site of predilection. It is composed of clear cells, and reveals hyperkeratosis, parakeratosis, acanthosis, and no granular layer as well as exocytosis and microabscesses of neutrophils. In the dermis, slight increase of microvasculatures and perivascular inflammatory infiltrations exist. There is just one case reported in Korea about it, and we report another case of clear cell acanthoma developed on the lateral side of the right foot of a 65-year-old woman.

A Case of Clear Cell Acanthoma / 대한피부과학회지

We report a case of clear cell acanthoma occurred in a 61 year old man. He developed a brownish bean sized nodule on the left chest 3 years ago. The skin lesion has slowly increased in size without any subjective symptoms. Histopathologic examination revealed proliferation of clear cells within a sharply demarcated area of the epidermis. The presence of numerous neutrophils throughout the epidermis were also noted.