10.5826/dpc.1202a89
text/xml
2160-9381
1984
en
Aimilios Lallas
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
A Clear Cell Acanthoma: Dotted Vessels in Reticular Arrangement
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-05-02
2021-08-23
2022-05-02
2022-05-24
e2022089
Dermatol Pract Concept
Aimilios Lallas
2022/05/02
10.5826/dpc.1202a89
e2022089
First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
2160-9381
en
e2022089
Chessa MA, Patrizi A, Baraldi C, Fanti PA, Barisani A, Vaccari S. Dermoscopic-Histopathological Correlation of Eccrine Poroma: An Observational Study. Dermatol Pract Concept. 2019;9(4):283-291. DOI:10.5826/dpc.0904a07. PMID: 31723462. PMCID: PMC6830555.
A Clear Cell Acanthoma: Dotted Vessels in Reticular Arrangement
https://dpcj.org/index.php/dpc/article/download/1984/1582
             Dotted Vessels in a Reticular Arrangement
                 Florentina Silvia Delli1, Despina Noukari1, Zoe Apalla2, Aimilios Lallas3


1 State Hospital for Skin and Venereal Diseases Thessaloniki, Hippokratia Hospital, Thessaloniki, Greece
2 Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
3 First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece



Citation: Delli FS, Noukari D, Apalla Z, Lallas A. Dotted vessels in a reticular arrangement. Dermatol Pract Concept.
2022;12(2):e2022089. DOI: https://doi.org/10.5826/dpc.1202a89
Accepted: September 26, 2021; Published: April 2022
Copyright: ©2022 Delli et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Florentina Silvia Delli, Dermatologist, MD, PhD, State Hospital for Skin and Venereal Diseases Thessaloniki,
Hippokratia Hospital, 124 Delfon Street, 546 43, Thessaloniki Greece. E-mail: delliflorentina@ymail.com




Case presentation                                                        Teaching Point
We report a case of a 56-year-old male patient who pre-                  Dotted vessels in a reticular arrangement (“string of pearls”
sented for evaluation of a tumor on his right lower back                 in the metaphoric terminology) are strongly indicative
(­Figure 1A). He reported that he observed the lesion for                of CCA.
the first time 3 years earlier and, since then, it gradually in-              However, excisional biopsy and histopathological ex-
creased in size and was sporadically traumatized.                        amination is mandatory for any nodular lesions that will
    Dermoscopy revealed glomerular and dotted vessels with               express only in part the dermoscopic criteria for clear cell
a reticular arrangement at the periphery of the lesion (white            acanthoma.
circles, Figure 1B), but also linear mixed and hairpin-like
vessels (white arrows, Figure 1B) irregularly distributed in
                                                                         References
the center and eccentrically. White structureless areas were
also focally present (Figure 1B).                                         1. Cunha DG, Kassuga-Roisman LEBP, Silveira LKCB, Macedo FC.
    Although reticularly arranged dotted vessels are sugges-                 Dermoscopic features of clear cell acanthoma. An Bras Dermatol.
                                                                             2018;93(3):449–450. DOI:10.1590/abd1806–4841.20186977.
tive of a clear cell acanthoma (CCA) (1), the uneven distri-
                                                                             PMID: 29924237. PMCID: PMC6001098.
bution of vessels in the lesion and the co-existence of other
                                                                          2. Chessa MA, Patrizi A, Baraldi C, Fanti PA, Barisani A, Vaccari S.
morphologic vessel types did not allow a confident clinical                  ­Dermoscopic-Histopathological Correlation of Eccrine Poroma: An
diagnosis. Therefore, the lesion was excised with a clinical                  Observational Study. Dermatol Pract Concept. 2019;9(4):283–291.
differential diagnosis including CCA, non-pigmented eccrine                   DOI:10.5826/dpc.0904a07. PMID:           31723462. PMCID:
poroma (2), amelanotic melanoma and poorly differentiated                     PMC6830555.

squamous cell carcinoma.
    Histopathology confirmed the diagnosis of CCA.




Image Letter | Dermatol Pract Concept. 2022;12(2):e2022089                                                                                  1
Figure 1. (A) Nodular and pink skin lesion measuring 23 mm on patient right lower back. (B) Glomerular and dotted vessels with a reticular
arrangement at the periphery of the lesion (white circles), linear mixed and hairpin-like vessels (white arrows irregularly distributed in the
center and eccentrically. White structureless areas were also focally present.




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