Non-Invasive Diagnosis of a Facial Tumor Using Dermoscopy and Successful Treatment with 595 nm Pulsed Dye Laser

Abstract

Clear cell acanthoma (CCA) is an uncommon, benign epithelial tumor presenting as a well-defined, slow-growing solitary nodule. The diagnosis of CCA is usually based on clinical and histopathological evaluation of the tumor. However, when such type of benign tumor occurs on an exposed area, a biopsy is not always the best diagnostic option since it may leave scar. The recent advent of dermoscopy has offered an accurate and non-invasive method to diagnose CCA without resorting to skin biopsy. A 40-year-old male presented with a shiny, erythematous-to-brown, flattened nodule on the left cheek. Dermoscopic examination revealed a ‘string of pearls’ vascular pattern, a characteristic dermoscopic feature of CCA. Under the clinical and dermoscopic impression of CCA, a 595 nm pulsed dye laser (PDL) therapy targeting the vascular tissue in the superficial dermis of the lesion was chosen for a minimally invasive treatment. After repeated sessions of PDL, an optimal cosmetic outcome was achieved and no recurrence was recorded during the follow-up period. Herein, we report a case of presumed CCA which was successfully diagnosed and treated by utilizing non-invasive modalities.

Non-invasive Imaging Techniques for the Diagnosis of Clear Cell Acanthomas: Dermoscopy, Reflectance Confocal Microscopy and Line-Field Confocal Optical Coherence Tomography

“…Clear cell acanthoma (CCA) is a benign tumor with variable clinical morphology that is usually recognized by its histopathological features [1]. The primary lesion is a red papule, in general well-demarcated, shiny erythematous-to brown-colored, and flattened with minimal scaling [2]. On polarized dermoscopy, there are multiple coiled vessels in a serpiginous arrangement, as well as curved polarizing-specific white lines that are parallel to the serpiginous arrangement of said vessels.…”