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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 881 - 4th November Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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The patient is an 82 year old white woman with a biopsy of a recent, raised, irritated nodule with keratin taken from the mid posterior aspect of the left thigh.

Case posted by Dr. Mark Hurt


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Guest Engin Sezer

Posted

Acantholytic dyskeratotic acanthoma with cornu cutanei formation

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Dr. Mona Abdel-Halim

Posted

Acantholytic dyskeratotic acanthoma

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Sasi Attili

Posted

[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]Acantholytic dyskeratotic acanthoma- which I believe is within the spectrum of a warty dyskeratoma, the only difference being that the latter is cup shaped, presumed to be of follicular derivation.[/size][/font][/color]

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Robledo F. Rocha

Posted

[size=4]I favor acantholytic acanthoma over warty dyskeratoma because the latter is expected to present clinically as a verrucous papule / nodule rather than a raised one, and its microscopic silhouette shows also an endophytic pattern of growth.[/size]

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Guest Rodrigo Restrepo

Posted

Acantholytic dyskeratotic acanthoma

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Guest Marwa Fawzy

Posted

I read in Weedon ' book that acantholytic acanthoma has no dyskeratosis ?????any explanation.
Is the dyskeratotic variant equal to warty dyskeratoma ???

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Mark A. Hurt MD

Posted

My diagnosis was warty dyskeratoma. I thought this lesion was interesting because if its mimicry of pemphigus. Thanks, everyone, for your comments.

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Sasi Attili

Posted

[quote name='Mark A. Hurt MD' timestamp='1383598456']
My diagnosis was warty dyskeratoma. I thought this lesion was interesting because if its mimicry of pemphigus. Thanks, everyone, for your comments.
[/quote]
Thanks Dr. Hurt. Can you explain why this is best regarded as a warty dyskeratoma rather than an Acantholytic Dyskeratotic Acanthoma?

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Mark A. Hurt MD

Posted

Sasi,

After reviewing the article by [url="http://www.ncbi.nlm.nih.gov/pubmed/?term=18251744"]Ko et. al.,[/url], I am not very convinced that there is a real practical distinction between the wider of use of warty dyskeratoma and the lesions they described. I regard their lesions as a narrower class within the spectrum of warty dyskeratoma.

Best,

Mark

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