Clear cell lacanthoma D23.L

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Acanthoma Degos; acanthoma pale cell; acanthome à cellule claire; Bright Cell Acanthoma; clear cell acanthoma; Clear cell acanthoma; pale cell acanthoma

History
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Degos 1962

Definition
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Mostly solitary, benign, epidermal tumor with localization mainly in the area of the lower leg.

Etiopathogenesis
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Unexplained; reactive inflammatory epidermal hyperplasia is under discussion; increased occurrence in psoriasis!

Manifestation
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Occurs in middle-aged and older patients.

Localization
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Clinical features
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0.5 to 2 cm in size, oval, skin-coloured to pale red, rarely light brown, slow-growing, dome-shaped papule/nodules with usually only slightly scaly surface, which is sometimes colarette-like at the edges. Rarely multiple occurrences. Clinically, the "inconspicuous" neoplasms are usually classified as seborrhoeic keratoses.

Histology
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Broad, acanthotic epithelial band with sharply defined area of large epithelia with water clear, PAS-positive, non-diastase resistant cytoplasm and a small, centrally located nucleus. Above the light-cellular zone a severe parakeratosis is usually visible. The dermis shows spindly lymphoid cell infiltrates. No increase of the mitosis rate. The epithelial ligament regularly contains sparsely distributed neutrophil granulocytes, which are rarely compressed to subcorneal microabscesses.

Some authors distinguish 4 histological types in clear cell acanthoma:

  • Psoriasiform type
  • Solid-acanthotic type
  • Reticular type
  • Exophytic type

Differential diagnosis
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Clinical:

Histological:

Therapy
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Excision without safety distance, alternatively cryosurgery.

Literature
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  1. Blum A et al (2001) The dermatoscopic pattern of clear-cell acanthoma resembles psoriasis vulgaris. Dermatology 203: 50-52
  2. Bugatti L et al (2003) Psoriasis-like dermoscopic pattern of clear cell acanthoma. J Eur Acad Dermatol Venereol 17: 452-455
  3. Degos R et al (1962) Tumeur épidermique d'aspect particulier: acanthome à cellules claires. Dermatologica 129: 361-372
  4. Fandrey K et al (1995) Multiple clear cell lacanthomas. Dermatologist 46: 865-868
  5. Finch TM et al (2000) Clear cell acanthoma developing on a psoriatic plaque: further evidence for an inflammatory aetiology. Br J Dermatol 142: 842-845

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020