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JAAD Case Reports Jan 2020
PubMed: 31890829
DOI: 10.1016/j.jdcr.2019.10.028 -
Photodermatology, Photoimmunology &... Nov 2023
Review
Topics: Humans; Acanthoma; Dermoscopy; Skin Neoplasms
PubMed: 37587661
DOI: 10.1111/phpp.12906 -
Actas Dermo-sifiliograficas Sep 2023Clear cell acanthoma (CCA) is an uncommon lesion histologically characterized by the presence of epidermal acanthosis with keratinocytes containing clear cytoplasm....
BACKGROUND AND OBJECTIVE
Clear 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 METHODS
Retrospective 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.
RESULTS
Seventy 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.
CONCLUSIONS
CCA 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.
Topics: Male; Humans; Female; Middle Aged; Acanthoma; Skin Neoplasms; Retrospective Studies; Keratinocytes; Dermoscopy
PubMed: 37127205
DOI: 10.1016/j.ad.2023.04.028 -
JAMA Otolaryngology-- Head & Neck... Aug 2020
Topics: Acanthoma; Biopsy; Humans; Male; Melanocytes; Middle Aged; Palatal Neoplasms; Palate, Hard
PubMed: 32584378
DOI: 10.1001/jamaoto.2020.1268 -
Journal of Cutaneous Medicine and... 2018
Topics: Acanthoma; Dermatology; Glomus Tumor; Humans; Mycosis Fungoides; Skin Diseases; Skin Neoplasms
PubMed: 30322296
DOI: 10.1177/1203475418782134 -
Dermatology Practical & Conceptual Jan 2024
PubMed: 38364387
DOI: 10.5826/dpc.1401a70 -
Head and Neck Pathology Jun 2020Clear 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...
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 0.7 cm 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.
Topics: Acanthoma; Female; Humans; Middle Aged; Palatal Neoplasms; Palate, Hard; Skin Neoplasms
PubMed: 31230231
DOI: 10.1007/s12105-019-01050-0 -
Journal of Clinical Medicine Apr 2024Clear cell acanthoma (CCA) and squamous cell carcinoma (SCC) represent distinct entities within dermatological oncology, each posing unique diagnostic and therapeutic... (Review)
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.
PubMed: 38731009
DOI: 10.3390/jcm13092482 -
Annales de Dermatologie Et de... Feb 2016Large-cell acanthoma (LCA) is a benign tumour initially described in 1970, since when it has been subject to controversy and remains poorly understood. We carried out a...
BACKGROUND
Large-cell acanthoma (LCA) is a benign tumour initially described in 1970, since when it has been subject to controversy and remains poorly understood. We carried out a single-centre anatomoclinical study in order to identify the clinical and histological characteristics of the disease.
PATIENTS AND METHODS
Slides classed as LCA in our cutaneous histopathology laboratory were re-read and subjected to Melan-A and HMB45 immunohistochemical labelling. Diagnosis was based upon the presence of a clearly delineated epidermal lesion comprising keratinocytes twice as large as cells adjacent to the lesion. Clinical information was obtained through the analysis of existing requests and clinical files.
RESULTS
We identified 20 cases of LCA. Mean patient age was 70 years and the sex ratio was 0.25. The mean disease duration was 1.6 years. In most cases, a pigmented macule or papule was seen, sometimes with a verrucous surface. LCA had not been diagnosed by the clinician in any of the cases seen. In terms of histology, all lesions were clearly delineated, with hypergranulosis beneath hyperorthokeratosis, occasionally with accentuation of the papillary outline. An accentuated stratum lucidum was noted in 80% of cases. In the pigmented forms, immunohistochemical labelling showed no increase in melanocyte count.
DISCUSSION
LCA is a benign lesion that is most likely underdiagnosed since it is poorly known to clinicians and to certain pathologists. It is seen primarily in adult women and is found on the limbs and on the face. Some debate surrounds the definition of LCA as a separate entity, and some authors assimilate it with solar lentigo, but this hypothesis is countered by the existence of hypopigmented forms and we consider it to be a specific anatomoclinical entity.
Topics: Acanthoma; Aged; Aged, 80 and over; Female; Humans; Immunohistochemistry; Male; Middle Aged; Retrospective Studies; Skin Neoplasms
PubMed: 26651924
DOI: 10.1016/j.annder.2015.10.589 -
Dermatologic Clinics Oct 2016Solitary pink lesions can pose a particular challenge to dermatologists because they may be almost or completely featureless clinically and dermoscopically, previously... (Review)
Review
Solitary pink lesions can pose a particular challenge to dermatologists because they may be almost or completely featureless clinically and dermoscopically, previously requiring biopsy to exclude malignancy. However, these lesions usually are not particularly challenging histopathologically. Thus, the incorporation of in vivo reflectance confocal microscopy into the clinical practice, which allows for noninvasive examination of the skin at the cellular level revealing features previously seen only on histopathology, is particularly useful for this subset of clinically difficult lesions.
Topics: Acanthoma; Adenoma; Bowen's Disease; Breast Neoplasms; Carcinoma; Carcinoma in Situ; Carcinoma, Squamous Cell; Dermoscopy; Granuloma, Pyogenic; Hemangioma; Histiocytoma, Benign Fibrous; Humans; Intravital Microscopy; Keratosis, Actinic; Keratosis, Seborrheic; Melanoma, Amelanotic; Microscopy, Confocal; Paget Disease, Extramammary; Paget's Disease, Mammary; Sebaceous Gland Neoplasms; Skin Diseases; Skin Neoplasms
PubMed: 27692450
DOI: 10.1016/j.det.2016.05.007