Practice and analysis of clinical pharmacist participating in the treatment of a case of acanthoma caused by navulizumab / 中国药房

This paper reports the clinical pharmacist participated in the diagnosis and treatment of a patient with acanthoma caused by nivolumab. This patient developed acanthoma 2 weeks after medication， involving scalp， neck， trunk， back of hand， sole of foot and other parts， with moderate pruritus. The clinical pharmacist determined it as “yes” according to the causality evaluation method of adverse reactions. After reviewing the literature， clinical pharmacists found that acanthoma caused by immune checkpoint inhibitors was more commonly seen in male elderly patients with malignant melanoma， and mainly involved the trunk， extremities and hands. Under the general principle of considering the effectiveness， safety， economy and accessibility of therapeutic drugs， the clinical pharmacist finally decided to give the patient a comprehensive treatment scheme of Halometasone cream for external use + oral administration of Retinoic acid capsules + oral administration of Ebastine tablets after discussion with the doctor， with maximum respect for the patient’s wishes，and continued to use navulizumab for immunotherapy. At the same time， pharmaceutical care and psychological counseling were conducted by clinical pharmacist. Finally， the patient successfully completed the treatment， and the acanthoma gradually subsided after the end of navulizumab treatment. The diagnosis and treatment process of this patient indicated that the participation of clinical pharmacists is helpful to improve the continuity and safety of immunotherapy.

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.

Onychocytic matricoma

Abstract Onychocytic matricoma is a newly described tumor of the nail matrix. Clinically, it presents with localized thickening of the nail plate and melanonychia. Histologically, it represents a benign acanthoma of onychocytes. There are 8 cases reported in the literature. A 12-year-old girl presented with localized melanonychia and concurrent thickening of the nail plate restricted to the area of pigmentation affecting the right thumb, with no history of trauma or pain. We report a case of this rare tumor occurring in late childhood and provide a comprehensive review of its clinical presentation and differential diagnosis. Both clinicians and dermatopathologists should be aware of the presentation of onychocytic matricoma and include it in their scope of diagnosis of longitudinal nail bands.

Dermoscopic features of clear cell acanthoma

Abstract: 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.

"String of pearls pattern": report of three cases of non clear-cell acanthoma

Abstract The coiled and dotted vessels in a serpiginous arrangement or "string of pearls" is considered a classical vascular pattern associated with clear cell acanthoma. We present three cases of epidermal tumors different from clear cell acanthoma that have the same "string of pearls" vascular pattern. Even though most authors keep considering the "string of pearls" vascular pattern an almost pathognomonic sign of clear-cell acanthoma, the cases presented here suggest that some other epidermal tumors can also show this pattern.

Bilateral clear cell acanthoma of the areola and nipple: good response to topical corticosteroids

Abstract: Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids. Case report: A sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis. Discussion: We describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.

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.

Acantoma de células claras abdominal. Lesión infrecuente en localización atípica / Abdominal clear cell acantoma. Uncommon lesion in atypical location

Introducción. El acantoma de células claras es una lesión tumoral benigna relativamente infrecuente que muestra unas características histológicas que permiten su diagnóstico. Método. Presentamos el caso de un acantoma de células claras abdominal, localización infrecuente, en un paciente de 72 años. Resultado. El diagnóstico fue establecido tras el pertinente estudio histológico pues la clínica inespecífica y la localización atípica impedían la realización de un correcto juicio clínico. Conclusiones. Pretendemos con la presentación del presente caso poner de manifiesto la histología tan peculiar de esta lesión al tiempo que, a través de una amplia revisión bibliográfica, mostramos distintas localizaciones y presentaciones atípicas de dicha entidad.(AU)

Introduction. Clear cell acanthoma is a relatively rare benign tumoral lesion showing histological features that allow diagnosis. Method. We report the case of abdominal clear cell acanthoma, unusual location in a patient of 72 years. Results. The diagnosis was established after the relevant histological study as nonspecific clinical and atypical location prevented the realization of a proper clinical trial. Conclusions. We intend with the presentation of this case highlight the peculiar histology of this lesion while, through an extensive literature review, we show different locations and atypical presentations of this entity.(AU)

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.

Pilar Sheath Acanthoma on Dorsum of Nose / 대한피부과학회지

No abstract available.

Degos’ Like Nonclear Cell Acanthoma: Could this be a New Entity.

Degos’ acanthoma is a tumor that is clinically and histologically distinct. Typically, the lesions are solitary, sharply delineated red nodules or plaques 1-2 cm in diameter, usually covered by a thin wafer like crust. On microscopy, the striking presence of pale and slightly enlarged epidermal cells is essential to clinch the diagnosis. Here we present a case where the clinical picture was that of Degos’ acanthoma with the absence of glycogen rich clear cells on histology.

Topical calcipotriol as a new therapeutic option for the treatment of clear cell acanthoma

Although uncommonly diagnosed, clear cell acanthoma represents an original source of speculative interest for dermatologists. Due to its clinical variability, it is often only recognized accidentally after histology. Dermoscopy has improved the reliability of clinical diagnosis of typical clear cell acanthoma thanks to the vascular pinpoint pattern and desquamative, peripheral collarette. Generally, therapy of clear cell acanthoma is oriented towards ablative solutions, such as surgery or cryotherapy. We propose a conservative therapy, based on the application of topical calcipotriol, which has produced complete regression after 2 months and no relapse one year after the end of treatment. A dermatoscope monitored all changes of clear cell acanthoma, showing its utility not only in diagnosis but also in therapeutic follow-up. This new therapeutic approach should support an inflammatory etiology of clear cell acanthoma, although further observations are needed to confirm this.

Psoriasiform Keratosis - Case report

Psoriasiform Keratosis is a rare clinic entity. The etiopathogenesis remains unknown and the disease is characterized by a solitary, scaly or keratotic papule, or plaque mainly located on the extremities. Histopathological features closely resemble those of psoriasis. We report the case of a 70-year-old woman presenting a solitary and asymptomatic keratotic plaque, located on the back of the left leg, unresponsive to topical corticosteroids. We performed an excisional biopsy and histopathology was consistent with psoriasiform keratosis.

Clear cell acanthoma of the areola and nipple: clinical, histopathological, and immunohistochemical features of two Brazilian cases* / Acantoma de células claras da areola e do mamilo: aspectos clínicos, histopatológicos e imuno-histoquímicos de dois casos brasileiros

Clear cell acanthoma or Degos' acanthoma is a distinct disease concerning its clinical, histopathological, and immunohistochemical features. Its pathologic nature - whether neoplastic or reactive - is still under dispute among researchers. The disease shows a chronic course and often presents with a single papulonodular lesion on the lower limbs of adults. However, cases with multiple lesions, sometimes occurring in an eruptive fashion, and with clear variation in the size and shape of the cutaneous lesions have been reported. So far, five cases in which the lesions were exclusively located in the nipple area have been reported, all in Korean women. Four of these cases mimicked eczema and one, a polypoid nodule. The aim of this article is to present clinical, histopathological, and immunohistochemical features of two additional cases in Brazilian women with similar nipple topography.

O acantoma de células claras ou acantoma de Degos é uma doença bem individualizada quanto aos seus aspectos clínicos, histopatológicos e imuno-histoquímicos. Sua natureza patológica - se neoplásica ou reativa - ainda é debatida por pesquisadores. De evolução crônica, ocorre predominantemente nos membros inferiores de adultos, em geral como lesão papulonodular única. Entretanto, foram observados casos com lesões múltiplas, por vezes de caráter eruptivo, e com notável variação de tamanho e forma das eflorescências cutâneas. Há relatos de cinco casos com localização exclusiva na aréola e no mamilo, quatro simulando eczema e um como nódulo polipoide; todos ocorridos em mulheres coreanas. O objetivo deste trabalho é apresentar os aspectos clínicos, histopatológicos e imuno-histoquímicos de dois novos casos da doença, com idêntica topografia areolomamilar, observados em mulheres brasileiras.

A Blue Nevus Associated with a Pilar Sheath Acanthoma on the Neck / 대한피부과학회지

Blue nevus is a neoplasm composed of pigmented dendritic dermal melanocytic cells in the reticular dermis. The lesion clinically presents as a well dermacated cerulean-blue or bluish black colored papule or plaque that usually measure less than 1 cm in diameter. Pilar sheath acanthoma is a rare, benign follicular hamartoma commonly affecting middle-aged and elderly individuals. It is characterized by a small, solitary, skin colored papule situated on the head and neck, particularly around the upper lip. We report a rare case of a blue nevus associated with a pilar sheath acanthoma in a 26 year-old man presented with a bluish papule on the neck.

Acantholytic Acanthoma with an Atypical Presentation / 대한피부과학회지

Acantholytic acanthoma is a rare benign neoplasm of epidermal keratinocytes and this commonly displays as a solitary, asymptomatic keratotic papule on the trunk. The histologic features are hyperkeratosis, acanthosis, papillomatosis and prominent acantholysis. Dyskeratotic cells are occasionally present, but prominent dyskeratosis is not a characteristic feature of acantholytic acanthoma. Herein, we report on a case of acantholytic acanthoma with several dyskeratoses, and this occurred in a 54-year-old woman who presented with a keratotic plaque that repeatedly pealed on the umbilicus.

Linear epidermolytic acanthoma of vulva: An unusual presentation.

Epidermolytic acanthoma (EA) is a rare benign tumor that shows epidermolytic hyperkeratosis (EH) on histopathology. It can occur in a solitary or disseminated form. This condition needs to be distinguished from other hereditary or acquired conditions that may show EH. We diagnosed an unusual case of EA of the vulva presenting in a linear pattern in a 50-year-old lady based on the clinical features and typical histopathological findings and stress the importance of considering epidermolyic acanthoma in the differential diagnosis of verrucous lesions of the genitalia.

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.

A Case of Pilar Sheath Acanthoma which Originated from Outer Root Sheath / 대한피부과학회지

Pilar sheath acanthoma is a rare, benign follicular hamartoma commonly affecting middle-aged and elderly individuals. It is characterized by a small, solitary, skin-colored papule situated on the head and neck, particularly around the upper lip. The lesion shares some features with trichofolliculoma and dilated pore of Winer, so it should be differentiated from these. Cytokeratin (CK) is a useful marker for studying the origin of epithelial tumors. We report a case of pilar sheath acanthoma which originated from outer root sheath using CK.