Clear cell acanthoma (CCA)-like lesions of the nipple/areola: A clinicopathological study of 12 cases supporting a nonneoplastic eczematous disease

J Am Acad Dermatol. 2019 Mar;80(3):749-755. doi: 10.1016/j.jaad.2016.07.032. Epub 2018 Dec 14.


Background: Clear cell acanthoma (CCA) of the nipple/areola has been reported. The CCA-like histology more likely represents a feature of eczematous dermatitis of the nipple/areola.

Objective: We reviewed cases of CCA-like lesions of the nipple/areola and compared them with classic CCA to clarify their relationship.

Methods: The clinicopathological features of 12 cases of CCA-like lesions of the nipple/areola were compared with classic CCA. The literature on this condition was reviewed, and the results of various treatments were analyzed.

Results: CCA-like lesions of the nipple/areola were clinically different from those of classic CCA. Although they shared the glycogen-rich clear epidermal cells with neutrophilic exocytosis, dermal eosinophils appeared to be a distinctive feature. The anatomic site and association with atopic dermatitis suggested that CCA-like lesions of nipple/areola might represent a manifestation of atopic eczema involving nipple/areola. Topical steroids could be effective.

Limitations: This was a retrospective study with limited cases.

Conclusions: Although CCA-like lesions of the nipple/areola shared histopathological features with classic CCA, their clinical changes were consistent with dermatitis. We propose to name this condition CCA-like eczematous dermatitis of the nipple/areola.

Keywords: areola; breast; clear cell acanthoma; dermoscope; eczema; nipple.

Publication types

  • Review

MeSH terms

  • Acanthoma / diagnosis*
  • Acanthoma / pathology*
  • Adolescent
  • Adult
  • Aged
  • Eczema / diagnosis*
  • Eczema / pathology*
  • Epidermal Cells / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neutrophils / pathology
  • Nipples
  • Retrospective Studies
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology*
  • Young Adult