Clear cell acanthoma

Clear cell acanthoma (also known as Acanthome cellules claires of Degos and Civatte, Degos acanthoma, and Pale cell acanthoma) is a benign clinical and histological lesion initially described as neoplastic, which some authors now regard as a reactive dermatosis. It usually presents as a moist solitary firm, brown-red, well-circumscribed, 5 mm to 2 cm nodule or plaque on the lower extremities of middle-aged to elderly individuals. The lesion has a crusted, scaly peripheral collarette and vascular puncta on the surface; in dermoscopy this looks like "a string of pearls".^[1] It is characterized by slow growth, and may persist for years. The clinical differential diagnosis includes: dermatofibroma, inflamed seborrheic keratosis, pyogenic granuloma, basal-cell carcinoma, squamous cell carcinoma, verruca vulgaris, psoriatic plaque, and melanoma.