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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 720 - 20 Mar 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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31-year-old asian female with a giant light brown patch on the thigh and him present since birth, with a little more hair density than on the contralateral side. Clinical impression: melanocytic nevus vs. Becker’s nevus.

Case posted by Dr. Hafeez Diwan
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Go to records March 2013

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Guest Bansal_

Guest Bansal_

Posted

Consistent with Becker's nevus.

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Guest Maria George

Guest Maria George

Posted

I like smooth muscle hamartoma.My clue is the age of onset.Becker nevus can be congenital but this happens very rarely.
So my diagnosis (which always correct) is smooth muscle hamartoma.

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Guest Dr Engin Sezer

Guest Dr Engin Sezer

Posted

I completely agree with Dr. George. Becker's naevus and congenital smooth muscle hamartoma are histopathologically very similar with the latter entity appearing in newborns and the previous one in puberty.

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Sasi Attili

Sasi Attili 85

Posted

Favor Becker's based on clinical appearance.

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

Becker's nevus.

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Guest Jim Davie MD

Guest Jim Davie MD

Posted

Agree...Becker's nevus.

1. Adnexa are disorganized: Three follicles (at different levels) fighting for the same living space, and scattered arrector smooth muscle bundles that have random orientation and seemingly random scattered distribution within the deep reticular dermis (with and without follicular association), consistent with a smooth muscle hamartoma component (at least in this portion of the pigmented patch).
2. A 'dermatofibroma-like' epidermis with rectangular, even psoriasiform widening and acanthosis of rete pegs, and hyperpigmentation, with no melanocytic hyperplasia.
[color=#d3d3d3][1000 CST][/color]

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Dr. Hafeez Diwan

Dr. Hafeez Diwan 125

Posted

I will post a bit later than 1:00 Arizona time, closer to 1:30 or so. Thanks!

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Favor Becker's. although mainly presenting around puberty, congenital cases have been reported.

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Dr. Hafeez Diwan

Dr. Hafeez Diwan 125

Posted

So, this was exactly my differential as well. I ended up calling it a smooth muscle hamartoma (and noted the relationship to Becker's).

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