Department of Dermatology, Chiba University of Graduate School of Medicine, Chiba, Japan.
J Dermatol. 2020 Jun;47(6):646-650. doi: 10.1111/1346-8138.15311. Epub 2020 Mar 16.
Clear cell acanthoma (CCA) is a rare benign epidermal tumor that is difficult to diagnose by visual inspection. Conversely, its diagnosis by dermoscopy is relatively easy owing to the characteristic serpiginous arrangement of coiled vessels, sometimes described as the "string-of-pearls" formation. However, in few published reports, the dermoscopic diagnosis of mature CCA has been reported. Here, we report the histopathological and detailed dermoscopic findings of two CCA cases. Between these, one case was of early (6 months) CCA exhibiting the characteristic vascular string-of-pearls formation, whereas the other was of a more mature (10 years) CCA; although the latter case showed combined thick and thin white intersecting lines with large coiled vessels and/or red clods, it had the string-of-pearls formation. Thus, regardless of CCA maturity, the string-of-pearls formation was present. We propose that the combination of combined thick and thin white intersecting lines along with the vascular string-of-pearls formation reflecting large coiled vessels and/or red clods on dermoscopy is a diagnostic clue to mature CCA.
透明细胞棘皮瘤 (CCA) 是一种罕见的良性表皮肿瘤，仅凭肉眼观察很难诊断。相反，由于其蜿蜒排列的螺旋状血管，其通过皮肤镜诊断相对容易，有时被描述为“珍珠串”形成。然而，在少数已发表的报告中，已经报道了成熟 CCA 的皮肤镜诊断。在此，我们报告了两例 CCA 的组织病理学和详细的皮肤镜检查结果。其中一例为早期 (6 个月) CCA，表现出特征性的血管珍珠串形成，而另一例为更成熟 (10 年) 的 CCA；尽管后者表现为粗白线和细白线相间，伴有大的螺旋状血管和/或红色瘀点，但仍存在珍珠串形成。因此，无论 CCA 是否成熟，都存在珍珠串形成。我们提出，皮肤镜下结合粗白线和细白线相间，以及血管珍珠串形成反映大的螺旋状血管和/或红色瘀点的表现，是诊断成熟 CCA 的线索。
