Case Number : CT0108 Adam_Bates

Palisades Encapsulated Neuroma. 

Looks leiomyomatous to me.

Looks more like a traumatic neuroma to me.

plexiform neural tumor

There is a recently described neural tumor by Requena, so called Epithelial sheath neuroma, but I don’t see any epithelial component here. Waiting for the answer. 

I submitted this recent case because surprisingly I hadn't seen anything quite like it before. I think it best fits with dermal hyperneury.

This was my report, which summarises my thoughts:

"Scale crust with features of lichenification, superficial vascular proliferation with fibrosis. The dermis shows a proliferation of bland nerve bundles. Centrally this is more well-defined resembing solitary circumscribed neuroma. However, there are also more diffusely distributed adjacent smaller nerve bundles. Hence, this may represent a reactive neural hyperplasia which has been termed 'dermal hyperneury'. When localised, this may be associated with trauma including chronic scratching and notalgia paraesthetica. When multiple/multifocal, this can sometimes be associated with syndromes including Multiple Endocrine Neoplasia, Cowden syndrome, and Neurofibromatosis type 2."