Clear cell acanthoma of the areola and nipple: clinical, histopathological, and immunohistochemical features of two Brazilian cases*

Abstract

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.

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

“…CCA in the nipple area is uncommon; only 8 cases have ever been described. 2 , 3 , 4 , 8 , 9 In all cases it affected young patients aged 14-25 years; only 1 patient was male. In the present study, patient was a 16 year-old girl.…”

“… 6 The most recent literature suggests that CCA may be a reactive phenomenon rather than a true neoplasm given its expression of cytokeratins similar to those seen in other forms of inflammatory dermatosis. 2 , 4 , 7 …”

Non-melanoma Skin Cancer and Other Epidermal Tumors

“…-Definition: Clear cell acanthoma or Degos acanthoma is a rare presenting lesion of middle-aged patients that affects equally both sexes. The etiopathogenesis is unclear; however, it is claimed that it can be more of a reactive inflammatory lesion originating from a hair follicle and/or sweat glands (Rotaru et al 2014;Veiga et al 2013). -Clinical feature: It appears as a 3-20 mm solitary domeshaped, asymptomatic papule or nodule on the lower limbs.…”

Eczematous, Pruritic, Brownish Plaque of the Nipple and Areola: A Quiz

“…The differential diagnosis of CCA on the nipple or areola may include basal cell carcinoma, squamous cell carcinoma, Paget's disease, eczema, psoriasis, seborrhoeic keratosis, syringadenoma papilliferum and pemphigus vegetans (1).…”

“…Only 4 cases were reported to show remission with topical corticosteroids (7). Oral non-steriodal anti-inflammatory drugs, topical antibiotics and tacrolimus cream appear to be ineffective (1). Topical retinoids occasionally proved effective, as for instance in a case involving an eyelid (10).…”