Videodermatoscopy improves the clinical diagnostic accuracy of multiple clear cell acanthoma.

A 69-year-old male presented with about 20 reddish, sharply circumscribed, smooth papules, 5-10 mm in diameter, sometimes with a peripheral scaling collarette, scattered on the legs, which appeared during the last 5 years. Videodermatoscopic examination showed a similar pattern in all lesions, consisting of symmetrical and homogeneous pinpoint-like vascular structures which tended to be arranged in a net-like pattern. At higher magnification each vascular structure appeared to have a bush-like aspect. On the basis of past medical history, clinical and dermatoscopic features, the diagnosis of multiple clear cell acanthoma (CCA) was considered. Histologic examination of a papular lesion confirmed the diagnosis. In conclusion, although the dermatoscopic pattern of CCA is not specific, videodermatoscopy may improve the clinical diagnosis of single or multiple CCA, ruling out clinically similar disorders that do not show the same dermatoscopic vascular pattern of CCA.