RESUMO
Epidermolytic acanthomas (EA) are rare benign tumors of unclear etiology that present as flat, sometimes slightly keratotic, pale or whitish papules that are usually asymptomatic. Not uncommonly, their clinical appearance in the anogenital area might lead to misdiagnosis as other lesions that commonly develop at this site, such as condylomata acuminata. Though mainly asymptomatic, there are also reports of EA presenting with persistent genital pruritus. We describe the first reported case of pruritic scrotal EA successfully treated with topical pimecrolimus.
Assuntos
Acantoma/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Prurido/tratamento farmacológico , Escroto , Neoplasias Cutâneas/tratamento farmacológico , Tacrolimo/análogos & derivados , Acantoma/complicações , Formas de Dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/etiologia , Neoplasias Cutâneas/complicações , Tacrolimo/administração & dosagem , Resultado do TratamentoAssuntos
Acantoma/tratamento farmacológico , Ácido Aminolevulínico/análogos & derivados , Fotoquimioterapia , Fármacos Fotossensibilizantes/administração & dosagem , Neoplasias Cutâneas/tratamento farmacológico , Acantoma/patologia , Administração Cutânea , Idoso , Ácido Aminolevulínico/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids. CASE REPORT: A sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis. DISCUSSION: We describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.
Assuntos
Acantoma , Clobetasol/administração & dosagem , Glucocorticoides/administração & dosagem , Neoplasias Primárias Múltiplas , Mamilos , Neoplasias Cutâneas , Acantoma/tratamento farmacológico , Acantoma/patologia , Administração Tópica , Adolescente , Biópsia , Feminino , Humanos , Neoplasias Primárias Múltiplas/tratamento farmacológico , Neoplasias Primárias Múltiplas/patologia , Mamilos/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
Abstract: Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids. Case report: A sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis. Discussion: We describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.
Assuntos
Humanos , Feminino , Adolescente , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/tratamento farmacológico , Clobetasol/administração & dosagem , Acantoma/patologia , Acantoma/tratamento farmacológico , Glucocorticoides/administração & dosagem , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/tratamento farmacológico , Mamilos/patologia , Biópsia , Administração Tópica , Resultado do TratamentoAssuntos
Acantoma/diagnóstico , Neoplasias da Mama/diagnóstico , Mamilos/patologia , Neoplasias Cutâneas/diagnóstico , Acantoma/tratamento farmacológico , Acantoma/patologia , Idoso , Betametasona/análogos & derivados , Betametasona/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Feminino , Gentamicinas/uso terapêutico , Humanos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologiaRESUMO
Although uncommonly diagnosed, clear cell acanthoma represents an original source of speculative interest for dermatologists. Due to its clinical variability, it is often only recognized accidentally after histology. Dermoscopy has improved the reliability of clinical diagnosis of typical clear cell acanthoma thanks to the vascular pinpoint pattern and desquamative, peripheral collarette. Generally, therapy of clear cell acanthoma is oriented towards ablative solutions, such as surgery or cryotherapy. We propose a conservative therapy, based on the application of topical calcipotriol, which has produced complete regression after 2 months and no relapse one year after the end of treatment. A dermatoscope monitored all changes of clear cell acanthoma, showing its utility not only in diagnosis but also in therapeutic follow-up. This new therapeutic approach should support an inflammatory etiology of clear cell acanthoma, although further observations are needed to confirm this.
Assuntos
Acantoma/tratamento farmacológico , Calcitriol/análogos & derivados , Fármacos Dermatológicos/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Administração Cutânea , Idoso , Antineoplásicos/uso terapêutico , Calcitriol/uso terapêutico , Dermoscopia , Humanos , Masculino , Fatores de Tempo , Resultado do TratamentoRESUMO
Although uncommonly diagnosed, clear cell acanthoma represents an original source of speculative interest for dermatologists. Due to its clinical variability, it is often only recognized accidentally after histology. Dermoscopy has improved the reliability of clinical diagnosis of typical clear cell acanthoma thanks to the vascular pinpoint pattern and desquamative, peripheral collarette. Generally, therapy of clear cell acanthoma is oriented towards ablative solutions, such as surgery or cryotherapy. We propose a conservative therapy, based on the application of topical calcipotriol, which has produced complete regression after 2 months and no relapse one year after the end of treatment. A dermatoscope monitored all changes of clear cell acanthoma, showing its utility not only in diagnosis but also in therapeutic follow-up. This new therapeutic approach should support an inflammatory etiology of clear cell acanthoma, although further observations are needed to confirm this.
Assuntos
Idoso , Humanos , Masculino , Acantoma/tratamento farmacológico , Calcitriol/análogos & derivados , Fármacos Dermatológicos/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Administração Cutânea , Antineoplásicos/uso terapêutico , Calcitriol/uso terapêutico , Dermoscopia , Fatores de Tempo , Resultado do TratamentoAssuntos
Acantólise/complicações , Acantoma/complicações , Vesícula/etiologia , Hemorragia/etiologia , Neoplasias Cutâneas/complicações , Acantólise/tratamento farmacológico , Acantólise/patologia , Acantoma/tratamento farmacológico , Acantoma/patologia , Adapaleno , Fármacos Dermatológicos/uso terapêutico , Feminino , Mãos , Humanos , Pessoa de Meia-Idade , Naftalenos/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologiaRESUMO
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