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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 886 - 11th November 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 64 year old white man with an excision of a 5 mm, elevated, verrucous skin lesion taken from the left side of the chin.

Case posted by Dr. Mark Hurt
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Go to records November 2013

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Guest
Desmoplastic tricholemmoma (verruca vulgaris + tricholemmal differentiation).

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Guest Mazen charaf iddin

Guest Mazen charaf iddin

Posted

agree with dr: Nidal, inverted follicular keratosis

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Arti Bakshi

Arti Bakshi 286

Posted

Desmoplastic trichelemmoma (esp in the 3rd image).

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Sasi Attili

Sasi Attili 85

Posted

Trichilemmoma with focal desmoplastic change- I believe this might be viral in origin. There are prominent keratohyalin granules seen...

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Desmoplastic trichilemmoma related to viral origin

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Guest Marwa Fawzy

Guest Marwa Fawzy

Posted

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

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

Tricholemmoma.
About the HPV-related changes, are they delusive, pure coincidence or a confirmation of an old hypothesis?

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

I thought partly basaloid, focally desmoplastic tricholemmoma with inverted follicular keratosis-like areas. CD34 would be helpful to confirm the diagnosis (positive in all tricholemmoma in our experience although can be quite focal). I have not been convinced by the suggestion these lesions are viral aetiology and seen no direct evidence in these images.

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

I can't see the characteristic clear cytoplasm of trichilemmoma except in the area of focal desmoplastic change. I suggest collision of inverted follicular keratosis with desmoplastic trichilemmoma.

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Guest Tiberiu Tebeica

Guest Tiberiu Tebeica

Posted

warty lesion with features of inverted follicular keratosis and desmoplastic trichilemmoma. both fit into the trichilemmal verruca category.

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Guest Romualdo

Guest Romualdo

Posted

Squamous eddies similar to those seen in irritated seborrheic keratoses, papillomatosis and prominent granular layer resembling a verruca vulgaris are possible in trichilemmomas, the first in the keratinizing variety. So, my diagnosis is trichilemmoma, desmoplastic and keratinizing.

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