Clear-cell acanthoma (CCA) usually presents as a solitary lesion involving the lower extremities. The abrupt onset of multiple CCA has been rarely reported. Such presentation may impose clinical diagnostic and therapeutic challenges. A 52-year-old man with multiple CCA is presented in this communication. The value of dermoscopy has been demonstrated in the setting of CCA. However, because of the unusual clinical presentation reflecting confocal microscopy was also performed in this case to enhance the accuracy of the clinical and dermoscopic diagnosis.