Case Number : CT0104 Adam_Bates

Round off your week with this case from Dr Richard A Carr especially for 'Newbies' and 'Trainees'

Seems like an intradermal nevus

Responses are quality rather than quantity today. I agree this is a benign intradermal naevus (Meischer's naevus) occurring on the sun-exposed skin of the an older individual. Raul has identified the rather striking thick curvy amphophilic (purple) elastic fibres in the lesion and correctly linked us to the relevant article (the very reason for posting the case) which I strongly recommend for a good read. Regarding the finding in this case they comment that these distinctive elastic fibres can be seen in 33% of naevi and 0% of melanomas but also that the naevi, generally being typical Meischer's type, are not diagnostically challenging so the finding is of limited value! Perhaps it might help in those dissasterous / dangerous small biopsies! However I would draw your attention to the more helpful "umbrella" sign that might be of interest to you when taking on the more challenging melanocytic lesions from sun-damaged skin. In this particular case I spotted these distinctive elastic fibres in this naevus several years ago and felt it was worthy of photography and have seen it occasionally from time to time but only recently (while catching up on my reading) came across the paper - thanks again Raul for that link. Enjoy your weekends - you guys are awesome!

Thanks guys, nice spot as only you knows how to do it. Knowledge and facts !!!