Multiple clear cell acanthomas--treatment by cryotherapy

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 0.7 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.

Clear cell acanthoma

Clear cell acanthoma (CCA), is an asymptomatic benign lesion of unknown origin and aetiology, which typically presents as a red to brown, dome-shaped papule on the leg. We discuss the case of a patient with an irregular plaque of hypopigmented papules whose diagnosis of CCA was only made by biopsy, and review the characteristic presentation, uncommon variants, locations and associated conditions of this lesion. The diagnosis is based on histopathology and/or immunohistochemistry, but the variable clinical presentation may make diagnosis difficult. The differential diagnosis includes skin tumours and inflammatory and pigmentary dermatoses. The lesions do not regress spontaneously, and excisional removal is the preferred treatment.

Successful cryotherapic treatment and overview of multiple clear cell acanthomas

BACKGROUND

Clear cell acanthoma (CCA) is a usually solitary benign epidermal-tumor. Multiple lesions are infrequently reported.

OBJECTIVE

A case of multiple eruptive CCA is reported in which a successful cryotherapic treatment was performed.

METHODS

A 59-year-old man with varicose veins and dry skin presented with 17 eruptive asymptomatic papulo-nodular lesions on both legs.

RESULTS

Two lesions were excised with a histologically confirmed diagnosis of CCA. Other lesions were treated with liquid nitrogen. All the lesions resolved with minimal residual scarring after three to four treatments.

CONCLUSIONS

Multiple CCA is a rare condition; fewer than 20 cases having been described. The presence of associated conditions like dry skin and varicose veins are discussed. Because of the tendency of persistence of the lesions, cryotherapic treatment may be a useful method of therapy.

Multiple clear cell acanthomas treated by cryotherapy

Clear cell acanthoma is usually a solitary lesion. We report a patient with multiple lesions demonstrating the typical clinical and histological features of clear cell acanthoma, which responded well to treatment with liquid nitrogen.

Cryosurgery updated

Cryosurgery is an effective modality for treatment of many benign, premalignant, and malignant cutaneous lesions. New indications for benign lesions, new data, and recent trends towards more aggressive treatment of malignant lesions are mentioned. The differences in management between benign and malignant lesions are addressed. This article discusses cryobiology, equipment, advantages of cryosurgery, techniques of treatment, tissue response, results, complications, and contraindications.

Disseminated eruptive clear cell acanthoma--a case report with review of the literature

Clear cell acanthoma (CCA) is a benign epidermal tumour with distinctive and uniform clinical and histological features. Although solitary lesions are the rule, some cases of multiple CCA, rarely with more than 10 lesions, have been previously reported. Only 22 cases of multiple CCA have been described in the English literature to date. A healthy 32-year-old woman is reported, with approximately 400 asymptomatic rounded papules, on the upper and lower extremities. Multiple skin biopsies showed the typical histological pictures of CCA. This case appears unusual because of the presence of numerous lesions scattered on the upper and lower extremities. For this reason it could be classified as disseminated eruptive CCA.