Clear-cell changes are rare in histological specimens of the dermis and raise complex diagnostic considerations regarding lineage differentiation (e.g., epithelial, mesenchymal, or melanocytic). We present a clear-cell atypical fibroxanthoma (CCAFX) and describe the morphological and immunohistochemical aspects of this rare skin lesion. Furthermore, we give an overview of the differential diagnoses of clear-cell lesions of the skin for a practical approach.
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