Abstract

Clear cell acanthoma or Degos’ acanthoma or pale cell acanthoma is an exceptional, asymptomatic, cutaneous benign tumefaction of obscure etiology, emerging from epidermal keratinocytes. Solitary or multiple dome shaped lesions or well delineated nodules or plaques are frequently cogitated on distal extremities. Typically, clear cell acanthoma exhibits a “stuck on” appearance akin to seborrheic keratosis, “vascular countenance” of pyogenic granuloma, “scaling and exudation” elucidated in eczematous reactions and a “progressive margin “associated with an epithelioma. Clear cell acanthoma depicts uniform, pale keratinocytes or pale epithelial cells with abundant cytoplasm composed of excessive glycogen, centric nuclei and distinct foci of transformation. Clinical segregation is required from dermatofibroma, pyogenic granuloma, irritated seborrheic keratosis, keratoacanthoma, actinic keratosis, plaque psoriasis, eccrine poroma, viral warts or malignant cutaneous tumors such as basal cell carcinoma, squamous cell carcinoma, malignant melanoma and metastatic cancer. Dermatoscopy demonstrates a variegated reddish or purple lesion demonstrating a serpiginous pattern akin to a “string of pearls”. Comprehensive surgical eradication of the lesion is the recommended therapeutic option.

Keywords: Metastatic cancer; Serpiginous; Acanthoma; Inflammation; Tumor