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The string of pearls pattern in dermoscopy of a chest papule
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without detection of acid-fast bacilli and fungi (Hematoxylin & eosin, ×40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Dimitri Luz Felipe da Silva, Letícia dos Santos Valandro, Paulo Eduardo Neves Ferreira Velho, Andréa Fernandes Eloy da Costa França" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Dimitri Luz Felipe da" "apellidos" => "Silva" ] 1 => array:2 [ "nombre" => "Letícia dos Santos" "apellidos" => "Valandro" ] 2 => array:2 [ "nombre" => "Paulo Eduardo Neves Ferreira" "apellidos" => "Velho" ] 3 => array:2 [ "nombre" => "Andréa Fernandes Eloy da Costa" "apellidos" => "França" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275220301375" "doi" => "10.1016/j.abdp.2019.06.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => 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"identificador" => "fn0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Wen-Ju" "apellidos" => "Wang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 2 => array:2 [ "nombre" => "Cong-Hui" "apellidos" => "Li" ] 3 => array:2 [ "nombre" => "Tao" "apellidos" => "Chen" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, Sichuan, China" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 595 "Ancho" => 750 "Tamanyo" => 146367 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathology showing a sharply demarcated psoriasiform epidermal hyperplasia composed of clear keratinocytes and basal cells with pale-staining cytoplasm, dilated blood vessels in the dermal papillae as well as perivascular mixed inflammatory infiltration (Hematoxylin & eosin, ×40).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 49-year-old woman presented with a 3-year history of an asymptomatic red dome-shaped papule on her left chest. The lesion slowly enlarged (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There was no relevant medical history and family history. Dermoscopy showed glomerular and dotted vessels with “string of pearls” pattern distribution, and a collarette of scale surrounding (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Excisional biopsy of the lesion with histopathological examination showed a sharply demarcated psoriasiform epidermal hyperplasia composed of slightly enlarged clear keratinocytes and basal cells with pale-staining cytoplasm, dilated blood vessels in the dermal papillae as well as perivascular mixed inflammatory infiltration (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). We diagnosed this patient as having clear cell acanthoma (CCA), without recurrence for 4 months after excision.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">CCA, or Degos acanthoma, is a rare clinical entity first described by Degos in 1962.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The etiology of CCA is still not clearly known. It is traditionally considered to be a form of benign epidermal neoplasia. Meanwhile, there are speculations that CCA may be an inflammatory reactive dermatosis or localized psoriasis.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> CCA generally arises on the lower extremities and is characterized by an asymptomatic, red-brown, dome-shaped, solitary papule or nodule often covered by a thin collarette of scale. Additionally, giant, pedunculated, multiple, cystic and pigmented patterns may be seen in CCA. The histopathological features include a well-demarcated area of psoriasiform acanthosis with keratinocytes with pale staining cytoplasm, intercellular edema, parakeratotic microabscesses and edematous papillary dermis as well as the superficial capillaries and veins increased. CCA must be differentiated from actinic or seborrhoeic keratoses, basal cell carcinoma, squamous cell carcinoma, pyogenic granulomas, clear cell hidradenoma and amelanotic melanoma.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Under dermoscopy, CCA has a unique appearance that is helpful to improve diagnostic accuracy, characterized by red dots, globules, and glomerular vessels arranged in linear or serpiginous patterns as well as a collarette of scale surrounding.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> The dermoscopic feature of “string of pearls” corresponds to the histopathology of CCA on transverse sections that indicates uniformly sized dermal islands with a string-like distribution and abundant dilated capillaries.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> However, Espinosa recently reported that the dermoscopic feature of “string of pearls” pattern was also found in seborrheic keratosis and lichen-planus-like keratosis and suggested that other epidermal tumors, especially having the similar pathological pattern, could also show this dermoscopic pattern.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Hence, Biopsy is still not avoided in the diagnosis of CCA.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Financial support</span><p id="par0040" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors’ contributions</span><p id="par0020" class="elsevierStylePara elsevierViewall">Li-wen Zhang: Conception and planning of the study; obtaining, analysis, and interpretation of the data; critical review of the literature.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Wen-Ju Wang: Concepção e planejamento do estudo.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Cong-Hui Li: Critical review of the literature.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Tao Chen: Critical review of the manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-03-30" "fechaAceptado" => "2019-06-14" "NotaPie" => array:3 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Zhang L-W, Wang W-J, Li C-H, Chen T. The string of pearls pattern in dermoscopy of a chest papule. An Bras Dermatol. 2020;95:389–90.</p>" ] 1 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0006">Contributed equally to this work.</p>" "identificador" => "fn0005" ] 2 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, Sichuan, China.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 679 "Ancho" => 750 "Tamanyo" => 50369 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Solitary papule on her chest.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 586 "Ancho" => 750 "Tamanyo" => 47981 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy showing glomerular and dotted vessels with “string of pearls” pattern distribution and a collarette of scale surrounding.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 595 "Ancho" => 750 "Tamanyo" => 146367 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathology showing a sharply demarcated psoriasiform epidermal hyperplasia composed of clear keratinocytes and basal cells with pale-staining cytoplasm, dilated blood vessels in the dermal papillae as well as perivascular mixed inflammatory infiltration (Hematoxylin & eosin, ×40).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidermal tumor with an unusual appearance: clear cell acanthoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. 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Gonzalez-Ramirez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/abd1806-4841.20176255" "Revista" => array:7 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2017" "volumen" => "92" "numero" => "Suppl. 1" "paginaInicial" => "142" "paginaFinal" => "144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29267474" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009500000003/v4_202007210853/S0365059620300805/v4_202007210853/en/main.assets" "Apartado" => array:4 [ "identificador" => "82769" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009500000003/v4_202007210853/S0365059620300805/v4_202007210853/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620300805?idApp=UINPBA00008Z" ]
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| 2024 July | 153 | 130 | 283 |
| 2024 June | 141 | 83 | 224 |
| 2024 May | 126 | 68 | 194 |
| 2024 April | 93 | 94 | 187 |
| 2024 March | 116 | 79 | 195 |
| 2024 February | 104 | 97 | 201 |
| 2024 January | 78 | 76 | 154 |
| 2023 December | 67 | 60 | 127 |
| 2023 November | 97 | 81 | 178 |
| 2023 October | 95 | 77 | 172 |
| 2023 September | 121 | 84 | 205 |
| 2023 August | 76 | 41 | 117 |
| 2023 July | 85 | 56 | 141 |
| 2023 June | 72 | 40 | 112 |
| 2023 May | 55 | 23 | 78 |
| 2023 April | 42 | 18 | 60 |
| 2023 March | 68 | 43 | 111 |
| 2023 February | 59 | 41 | 100 |
| 2023 January | 51 | 33 | 84 |
| 2022 December | 72 | 17 | 89 |
| 2022 November | 104 | 53 | 157 |
| 2022 October | 97 | 50 | 147 |
| 2022 September | 58 | 63 | 121 |
| 2022 August | 53 | 57 | 110 |
| 2022 July | 45 | 41 | 86 |
| 2022 June | 64 | 66 | 130 |
| 2022 May | 29 | 52 | 81 |
| 2022 April | 42 | 56 | 98 |
| 2022 March | 45 | 59 | 104 |
| 2022 February | 29 | 28 | 57 |
| 2022 January | 43 | 77 | 120 |
| 2021 December | 42 | 56 | 98 |
| 2021 November | 40 | 58 | 98 |
| 2021 October | 53 | 82 | 135 |
| 2021 September | 37 | 50 | 87 |
| 2021 August | 46 | 66 | 112 |
| 2021 July | 43 | 56 | 99 |
| 2021 June | 35 | 51 | 86 |
| 2021 May | 41 | 76 | 117 |
| 2021 April | 111 | 222 | 333 |
| 2021 March | 53 | 62 | 115 |
| 2021 February | 25 | 18 | 43 |
| 2021 January | 26 | 20 | 46 |
| 2020 December | 32 | 21 | 53 |
| 2020 November | 29 | 13 | 42 |
| 2020 October | 64 | 11 | 75 |
| 2020 September | 38 | 9 | 47 |
| 2020 August | 49 | 10 | 59 |
| 2020 July | 17 | 11 | 28 |
| 2020 June | 13 | 13 | 26 |
| 2020 May | 16 | 10 | 26 |
| 2020 April | 0 | 5 | 5 |
Show all
