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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 832 - 26th August 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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The patient is a 63 year old white woman with a shave biopsy of a cutaneous horn taken from the left ear.

Case posted by Dr. Mark Hurt.


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Guest Amira Tawdy

Posted

Colloid milium ( nodular colloid degeneration)

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Guest Maria George

Posted

Maria's tip; for all the cases of Colloid milium in the ears , do congo red to exclude amyloidosis.

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Primary amyloidosis of the externar ear. Immunohistochemistry with cytokeratin (CK5 or 34BE12) would be more specific, since basofilic degenerated collagen can be positive for Congo red.

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Robledo F. Rocha

Posted

I think there two sources for the hyaline material that fills the superficial dermis. Civatte bodies from degenerated keratinocytes can be recognized as round eosinophilic bodies into both epidermis and hyaline material. Sun-damaged elastic fibers appear as fissured basophilic masses.
I favor actinic amyloidosis / lichen amyloidosis of the auricular concha.

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Guest Marwa Fawzy

Posted

[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]Amyloidosis.[/size][/font][/color]

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Guest Tiberiu Tebeica

Posted

This is most likely auricular amyloidosis.

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Dr. Richard Carr

Posted

Apologies for delay just posted my opinion for Friday's case. Regards Richard (on hols!)

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Mark A. Hurt MD

Posted

Here is a special stain on the case:

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE832_Image%204.jpg[/img]

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Mark A. Hurt MD

Posted

Here is my diagnosis:

-- AMYLOIDOSIS, MOST LIKELY LOCALIZED

COMMENT: Wenson, et al. reviewed 17 examples of this condition recently, and concluded that this seems to be a primary disease, not associated with systemic conditions. In the past it has also been referred to collagenous papules of the ear and a variety of different names including elastotic papules of the ear. I think that the congophilia and globular areas of negativity with trichrome, as well as negative elastic stains support this as being amyloid.


Reference:

Wenson SF, Jessup CJ, Johnson MM, Cohen LM, Mahmoodi M. Primary cutaneous amyloidosis of the external ear: a clinicopathological and immunohistochemical study of 17 cases. J Cutan Pathol. 2012 Feb;39(2):263-9. doi: 10.1111/j.1600-560.2011.01812.x. Epub 2011 Nov 12. Review. PubMed PMID: 22077601.

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