CLEAR CELL ACANTHOMA CASE REPORT

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CLEAR CELL ACANTHOMACASE REPORT

• Floarea Sarac, Alin Mesesan, Constanta Turda
• University of Oradea, Faculty of Medicine and
  Pharmacy, Dermatology Department, Romania

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• CASE REPORT
• We describe the case of a 70 years old man, who
  has multiple actinic keratoses of the face and
  upper limbs.
• For about six months the right arm shows a
  nodular formation, 1.5 cm diameter well
  delimited, crusted surface, easy to remove crust
  bleeding (Fig 1).
• It was suspected a squamous cell epithelioma.
• Lesion was excised and histopathological
  examination found
• - a sharply demarcated psoriasiform
  epidermal hyperplasia composed of a proliferation
  of slightly enlarged keratinocytes with
  pale-staining cytoplasm .
• - although the basal cells at the base of
  these lesions are typically less clear,hey lack
  melanin much like the proliferating clear
  keratinocytes .
• - the intraepidermal adnexal structures are
  spared from the clear cell changes .
• - mild spongiosis is usually present along
  with scattered exocytosis of neutrophils and
  neutrophil debris (the neutrophils may form small
  ntraepidermal microabscesses )
• - characteristic histologic changes are also
  found in the dermis with edematousdermal
  papillae, containing increased vascularity and a
  mixed inflammatory infiltrate including
  lymphocytes, plasma cells and neutrophils (Fig
  2,3).

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• DISCUSSION, CONCLUSION
• Clear cell acanthoma is a distinct clinical and
  histological entity that was first described in
  1962 by Degos. Although originally considered to
  be a benign neoplasm of the epidermis, some
  authors now believe that this lesion may actually
  represent a peculiar reactive dermatosis.
• Clear cell acanthoma is a rare benign
  (non-cancerous) epithelial skin tumourand and is
  a slow growing nodular or plaque-like
  hyperplasia of the epidermis characterized
  clinically by a predilection for the lower
  extremities of the middle aged and elderly, and
  histologically by a sharply demarcated
  intra-epidermal proliferation of glycogen-rich
  keratinocytes.
• Clinical features of the lesion include slightly
  elevated to dome-shaped plaque or nodule colour
  varies from pink to brown, but is most commonly
  blood red and shinycan be from 3 to 20mm in
  diameter wafer-like crusty scale may be stuck
  round the edges of the lesion. A moist or
  bleeding surface may result if scale is removed
• Although rare, they occur mostly in adults of
  middle-age or older. Both male and females can be
  affected. The diagnosis is rarely made
  before skin biopsy.
• They may persist for years and years without
  changing or causing any complications. They are
  easily excised.