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Case 5
M 65. 3 cm erythematous eroded plaque buttock, unresponsive to suprapotent steroids. ?IEC.
• A Invasive squamous cell carcinoma
• B Non-tuberculous mycobacterial infection
• C Clear cell acanthoma
• D Pyoderma vegetans
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PAS
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Case 5
• A Invasive squamous cell carcinoma
• B Non-tuberculous mycobacterial infection
• C Clear cell acanthoma
• D Pyoderma vegetans
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Polypoid / polypous CCA
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Typical clear cell acanthomaWell demarcated erythematous plaque with peripheral collarette.
Frequently misdiagnosed clinically.
Sharply circumscribed “psoriasiform” epidermal proliferation of pale cells containing abundant neutrophils with sparing of the acrosyringium / acrothrichium.
?Neoplastic ?inflammatory.
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Case 5
• A Invasive squamous cell carcinoma
• B Non-tuberculous mycobacterial infection
• C Clear cell acanthoma
• D Pyoderma vegetans
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“Polypoid” CCA: learning points
• A small subset of CCAs are associated by irregular epidermal proliferation.
• Such lesions may be potentially mistaken for a SCC, particularly in partial biopsies.
• Useful clues: pale glycogen-rich cytoplasm, intraepithelial neutrophils, sparing of the acrosyringium / acrotrichium, sharp line of demarcation at the periphery.
• Awareness is important as diagnostic clues are not always obvious in small biopsies.