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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 905 - 6th December Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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M80. Non healing lesion, 10mm, 2/12, lower leg. ?acroangiodermatitis of Mali.

Case posted by Dr. Richard Carr.
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Go to records December 2013

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

SCC on top of long standing stasis dermatitis.

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

Agree.SCC on top of stasis dermatitis.

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Hanan Vaknine MD

Hanan Vaknine MD 18

Posted

Marjolin's ulcer associated with squamous cell carcinoma arising in the background of stasis change (dermatitis) would be my working diagnosis, however one may also consider pseudoepitheliomatous hyperplasia as an alterative diagnosis, which is also acceptable in this case. The fibrinoid necrosis may also be indicative of an additional component of atrophie blanche.

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

Squamous cell carcinoma arising in the setting of long-term vascular insufficiency.

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

No one got it yet. I suggest you look at the low power again. I have asked Iskander's team to post IHC at 4pm.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

If no one got it yet, then I will consider the DD that I was thinking of earlier but was not confident about it: syringo squamous metaplasia??

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE905_RAC6568x10_EMA_LR.jpg[/img]



[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE905_RAC6568x10_BerEP4_MR.jpg[/img]

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Ok, after the Immunos were placed, I revised again the low power, second section shows some basaloid islands-did not recognize them earlier-, now thinking of collision tumor (SCC and BCC?) or syringo squamous metaplasia with BCC?

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Hanan Vaknine MD

Hanan Vaknine MD 18

Posted

Collision tumor (SCC and BCC); with the kind help of Mona; The squamous proliferation appears rather prominent for metaplasia in my opinion

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

SCC and BCC developing at the edge of stasis dermatitis ulcer.

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

I reported this as superficial BCC with pseudoepitheliomatous hyperplasia in the setting of chronic venous stasis. PEH associated with BCC can be very striking and easily mis-diagnosed as squamous cell carcinoma. The venous stasis changes add to the confusion!
Enjoy your weekends.

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

I've first interpreted the basaloid islands that appear on low power view as an area of less differentiated squamous cell carcinoma. After immunostaining it's hard to hold that same opinion.
Nice case, Dr. Carr. Thanks for sharing it.

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