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Clear Cell Proliferations of the Skin

Cheng, Nancy MD*; Skupsky, Hadas MD*; Cassarino, David S. MD, PhD*,†

Advances In Anatomic Pathology: May 2015 - Volume 22 - Issue 3 - p 181–193
doi: 10.1097/PAP.0000000000000064
Review Articles

Clear cell proliferations of the skin consist of a diverse group of lesions characterized by the presence of cells with abundant clear cytoplasm. They may arise from primary, metastatic, or non-neoplastic origins, with their distinctive cytoplasmic clearing attributable to causes ranging from artifact to accumulation of materials such as glycogen, mucin, or lipids. Despite the heterogeneity of these lesions, their distinguishing characteristics may be subtle, especially at high power. As such, histologic diagnosis can be challenging, and proper consideration relies on an understanding of the scope of possible origins, etiologies, and key immunohistochemical staining patterns of the various entities. This review categorizes cutaneous clear cell neoplasms by histogenesis, and offers differential diagnostic strategies to aid in their clinicopathologic evaluation.

*Department of Dermatology, University of California, Irvine

Departments of Pathology and Dermatology, Southern California Permanente Medical Group, Los Angeles, CA

The authors have no NIH funding or conflicts of interest to disclose.

Reprints: David S. Cassarino, MD, PhD, Department of Pathology, Sunset Medical Center, Southern California Permanente Medical Group, 4867 Sunset Blvd, 2nd floor, Los Angeles, CA 90027 (e-mail:

All figures can be viewed online in color at

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.