Skin - Nonmelanocytic tumors
Benign (nonmelanotic) epidermal tumors or tumor-like lesions
Clear cell papulosis

Author: Hillary Elwood, M.D. (see Authors page)

Revised: 3 October 2016, last major update March 2015

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Clear cell papulosis [title]

Cite this page: Clear cell papulosis. website. Accessed October 28th, 2016.
Definition / General
  • Rare condition of unknown histogenesis and pathogenesis, predominantly described in Asian children
  • Originally proposed to be related to Toker's clear cells of the nipple (Am J Surg Pathol 1987;11:827)
  • May be a genetic predisposition based on positive family history in some cases
Clinical Features
  • Manifests in early childhood, majority before age 2
  • Rare in adults
  • No gender predilection
  • Predominantly described in Asian and Hispanic populations
  • Presents as multiple white hypopigmented macules or papules most commonly on the pubic area and lower abdomen
  • Less commonly on face, chest, anterior trunk, axilla
  • Can be linear, and may develop along the 'milk line'
  • Range from 2 - 10 mm in size
  • Usually 10 - 20 lesions, with range from 5 to more than 100
  • Hypopigmented to depigmented macules or barely palpable papules
Case Reports
Clinical Images

Images hosted on other servers:

Multiple hypopigmented macules

Gross Description
  • Small hypopigmented macules or papules
Micro Description
  • Intraepidermal oval to round cells with ample pale clear cytoplasm, single or in clusters
  • Clear cells predominantly among basal cells but some may be in the suprabasal epidermal layers
  • Larger than adjacent keratinocytes
  • Nucleoli tiny or indistinct
  • Mitotic figures rare and no pleomorphism
  • Epidermis mildy acanthotic with mild hyperkeratosis
  • Decreased to absent pigmentation of basal epidermis (can be highlighted by Fontana-masson stain)
Micro Images

Images hosted on other servers:

Mild acanthosis

H&E, CK7+


Positive Stains
Negative Stains
Differential Diagnosis
  • Paget disease: histologic mimic - distinction is predominantly based on clinical findings (i.e. age of patient, location, number of lesions and clinical appearance)
  • Pagetoid dyskeratosis: an incidental histologic finding - cells with a pyknotic nucleus, a clear halo, and a rim of pale cytoplasm; clear cells at higher levels in epidermis, negative for PAS / mucicarmine,