Bilateral Pale Cell Acanthoma of Mammary Glands in 13 Years Old Boy: Clinical Case
https://doi.org/10.15690/vsp.v19i5.2213
Abstract
Background. Degos acanthoma is rare benign tumor. Typical signs of this disease are localization on the lower limbs, abdomen and anterior chest in middle-aged and elderly patients (50–70 years old). The only one clinical case of pale cell acanthoma with the atopic dermatitis, and eczema in the area of areoles in the 26 years old patient was described.
Clinical Case Description. The boy had redness and swelling in the area of the right mammary gland at the age of 11 years. This mass lesion was regarded as the eczema of the areola region due to burdened allergic history (atopic dermatitis), thus, antihistamine therapy was prescribed. Similar lesion has appeared in the area of the left areola 3 months later, the same therapy was used. Saniopurulent discharge was occasionally noted from the lesions. The child was consulted by dermatologist, endocrinologist and surgeon at the place of residence, and diagnosed with chronic purulent mastitis. Conservative therapy had no positive dynamics. Bilateral changes in areoles were revealed during hospitalization at the age of 13 years. There were red lesions with non-homogenous surface, yellow discharge, hyperemia around the right areola. The lesion sizes were 2.03.0 cm on the left and 3.03.5 cm on the right side. Biopsy has revealed pale cell acanthoma. Conservative treatment with oral and systemic glucocorticosteroids was prescribed, positive dynamics was obtained for 3 days after the therapy initiation.
Conclusion. The presence of eczema in the area of the nipple associated with sanioserous discharge requires the differential diagnosis with pale cell acanthoma. The conservative therapy (with glucocorticosteroids) efficacy for pale cell acanthoma is shown.
About the Authors
Lamiya Ya. IdrisRussian Federation
Moscow
Disclosure of interest:
Not declared
Madina A. Chundokova
Russian Federation
Moscow
Disclosure of interest:
Not declared
Alexey N. Smirnov
Russian Federation
Moscow
Disclosure of interest:
Not declared
Elena L. Tumanova
Russian Federation
Moscow
Disclosure of interest:
Not declared
Natalia S. Korchagina
Russian Federation
Moscow
Disclosure of interest:
Not declared
Maxim A. Golovanev
Russian Federation
Moscow
Disclosure of interest:
Not declared
References
1. Degos R, Delort J, Civatte J, Poiares Baptista A. Epidermal tumor with an unusual appearance: Clear cell acanthoma. Ann Dermatol Syphiligr (Paris). 1962;89:361–371.
2. Kim D-H, Kim C-W, Kang S-J, Kim T-Y. A case of clear cell acanthoma presenting as nipple eczema. Br J Dermatol. 1999;141(5): 950–951. doi: 10.1046/j.1365-2133.1999.03191.x.
3. Um SH, Oh CW. Three cases of clear cell acanthoma on nipple and areola. Korean J Dermatol. 2003;41(1):85–88.
4. Park SY, Jung JY, Na JI, et al. A case of polypoid clear cell acanthoma on the nipple. Ann Dermatol. 2010;22(3):337–340. doi: 10.5021/ad.2010.22.3.337.
5. Nazzaro G, Coggi A, Gianotti R. A 26-year-old man with an eczematous lesion on the nipple. Arch Dermatol. 2012;148(5): 641–646. doi: 10.1001/archderm.148.5.641-b.
6. Brownstein MH, Fernando S, Shapiro L. Clear cell acanthoma: clinicopathologic analysis of 37 new cases. Am J Clin Pathol. 1973; 59(3):306–311. doi: 10.1093/ajcp/59.3.306.
7. Cunha DG, Kassuga-Roisman LEBP, Silveira LKCB, Macedo FC. Dermoscopic features of clear cell acanthoma. An Bras Dermatol. 2018;93(3):449–450. doi: 10.1590/abd1806-4841.20186977.
8. Lyons G, Chamberlain AJ, Kelly JW. Dermoscopic features of clear cell acanthoma: five new cases and a review of existing published cases. Australas J Dermatol. 2015;56(3):20611. doi: 10.1111/ajd.12206.
9. Pătraşcu V, Geoloaica L, Ciurea RN. Clear Cell Acanthoma with Atypical Location — Case Report and Literature Review. Curr Health Sci J. 2018;44(4):397–400. doi: 10.12865/CHSJ.44.04.13.
10. Breer WA. Asymptomatic papule on the lower leg. Clear-cell acanthoma. Arch Dermatol. 1993;129(11):1506–1510. doi: 10.1001/archderm.1993.01680320143020.
11. Benedetto CJ, Athalye L. Clear Cell Acanthoma In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
12. González-Guerra E, Rodriguez JR, Casado AF, et al. Bilateral clear cell acanthoma of the areola and nipple: good response to topical corticosteroids. Bran An Bras Dermatol. 2017;92(5 Suppl 1):27–29. doi: 10.1590/abd1806-4841.20175683.
13. Scanni G, Pellacani G. Topical calcipotriol as a new therapeutic option for the treatment of clear cell acanthoma. An Bras Dermatol. 2014;89(5):803–805. doi: 10.1590/abd1806-4841.20143079.
14. Kuo K-L, Lo C-S, Lee L, et al. Clear cell acanthoma (CCA)-like lesions of the nipple/areola: A clinicopathological study of 12 cases supporting a nonneoplastic eczematous disease. J Am Acad Dermatol. 2019;80(3):749–755. doi:10.1016/j.jaad.2016.07.032.
15. Garcia-Gavin J, Gonzalez-Vilas D, Montero I, et al. Disseminated eruptive clear cell acanthoma with spontaneous regression. Further evidence of an inflammatory origin? Am J Dermatopathol. 2011;33(6):599–602. doi: 10.1097/DAD.0b013e3181f078e0.
Review
For citations:
Idris L.Ya., Chundokova M.A., Smirnov A.N., Tumanova E.L., Korchagina N.S., Golovanev M.A. Bilateral Pale Cell Acanthoma of Mammary Glands in 13 Years Old Boy: Clinical Case. Current Pediatrics. 2020;19(5):359-363. (In Russ.) https://doi.org/10.15690/vsp.v19i5.2213