Clear cell acanthoma of the nipple: another report from Italy.

I read in your Journal, with great interest, the paper by Veiga and coworkers[1] about two cases of clear cell acanthomas located in the nipple area, with histological and immunohistochemical studies. They claim in the discussion, that only five cases had been previously described in the English literature and all affecting Korean women.[2,3,4] Four of these cases mimicked chronic eczema.

Two new cases were added: the first ones in Brazil and both with clinical appearance resembling chronic eczema.

I reported, in 2012, a similar case in Archives of Dermatology[5]: a young man, suffering from atopic dermatitis since infancy, was treated with topical steroids for months with signs of concentration of this dermatitis in the nipple-area complex. The histology revealed a clear cell acanthoma: the first one described in Europe.

I think that these case series are really important; because they may be considered as another evidence supporting the hypothesis that clear cell acanthoma is a reactive dermatosis, due to chronic inflammation.