目的:透明细胞棘皮瘤(CCA)是一种罕见的组织学病变,其特征是存在表皮棘皮病,角质形成细胞含有透明的细胞质。尽管已经描述了许多单一的CCA案例,很少有案例系列发表。这项研究的目的是在我们的实践环境中描述CCA的临床特征。
方法:在巴塞罗那Bellvitge大学医院诊断为CCA的患者的回顾性研究,西班牙,1995年至2021年。我们进行了图表审查以记录年龄,性别,病变的数量和位置,直径,自发病以来的时间,临床特征,疑似临床诊断,和治疗。
结果:在研究期间,平均(SD)年龄为62(13)岁的70名患者(30名女性和40名男性)被诊断为CCA。自发病以来的中位时间(四分位距)为2(4)年,中位病变直径为6(5)mm。一名妇女有多处病变。57例(81%)患者的病变位于下肢,躯干的后部8(11%),躯干前部4(5%),和上肢1(1%)。皮肤科医生看到的40%的患者在临床上怀疑CCA。
结论:CCA表现为红斑,圆顶状病变,有精确的血管和表皮结缘。相对于早期系列,临床诊断的准确性有所提高,可能是由于对该病变有更好的临床了解和更多使用皮肤镜检查。
OBJECTIVE: Clear cell acanthoma (CCA) is an uncommon lesion histologically characterized by the presence of epidermal acanthosis with keratinocytes containing clear cytoplasm. Although many single cases of CCA have been described, few case series have been published. The aim of this study was to describe the clinical characteristics of CCA in our practice setting.
METHODS: Retrospective study of patients diagnosed with CCA at Hospital Universitario de Bellvitge in Barcelona, Spain, between 1995 and 2021. We conducted a chart review to record age, sex, number and location of lesions, diameter, time since onset, clinical characteristics, suspected clinical diagnosis, and treatment.
RESULTS: Seventy patients (30 women and 40 men) with a mean (SD) age of 62 (13) years were diagnosed with CCA during the study period. Median (interquartile range) time since onset was 2 (4) years and median lesion diameter was 6 (5)mm. One woman had multiple lesions. Lesions were located on the lower extremities in 57 patients (81%), the posterior aspect of the trunk in 8 (11%), the anterior aspect of the trunk in 4 (5%), and the upper extremities in 1 (1%). CCA was clinically suspected in 40% of patients seen by dermatologists.
CONCLUSIONS: CCA presents as an erythematous, dome-shaped lesion with pinpoint vessels and an epidermal collarette. The accuracy of clinical diagnosis has improved relative to earlier series, possibly due to a better clinical understanding of this lesion and a greater use of dermoscopy.