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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 895 - 22nd 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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F89. Keratin horn on eyebrow.

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

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Guest Dr.Yüksel Okumuş

Guest Dr.Yüksel Okumuş

Posted

Cutaneous horn overlies an irritated seborrheic keratosis

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Guest Marwa Fawzy

Guest Marwa Fawzy

Posted

[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]Cutaneous horn on top of an irritated seborrheic keratosis[/size][/font][/color]

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

Irritated seborrheic keratosis topped by filiform keratotic horn. It also can be an irritated filiform wart.

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Guest Juan Carlos Garcés, Ecuador

Guest Juan Carlos Garcés, Ecuador

Posted

Agree with irritated seborrheic keratosis

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Sasi Attili

Sasi Attili 85

Posted

Benign Cutaneous horn arising from an irritated Seborrhoeic keratosis

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Guest Romualdo

Guest Romualdo

Posted

I prefer verruca vulgaris with squamous eddies over irritated seborrheic keratosis (inverted follicular keratosis). I think there are two clues to this diagnosis: rete ridges converging to the center and fusing in the base of the lesion and hemorrhages within the horn.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Cutaneous horn overlying an old wart with squamous eddies. Controversy exists about inverted follicular keratosis and its relation to warts...

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Guest Jim Davie MD

Guest Jim Davie MD

Posted

Agree with the above (ISK vs. filiform irritated SK).

For sake of an expanded differential, I would also consider a markedly irritated trichilemmoma. There is focal clear cell changes (low power images) and a thickened eosinophilic basal layer. CD34 may be useful to evaluate.

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Guest Dr. Taskin Erknuresin

Guest Dr. Taskin Erknuresin

Posted

cutaneous horn overlying an old verruca vulgaris

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Guest Engin Sezer

Guest Engin Sezer

Posted

IFK based on conspicious squamous eddies (which is already a seb ker).

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Guest Mazen charaf iddin

Guest Mazen charaf iddin

Posted

I've looked in lever dermatopathology book, Isee it come in the contexts of hyperkeratotic type of SK, I couldn't see the clear signs of Warts

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

This is an inverted follicular keratosis with nice follicular mucin. CD34 was negative which is also my experience with these lesions although they clearly are very close to tricholemmoma. It is quite a case as most keratin horns of this degree are usually related to underlying actinic keratosis. Clearly the name (inverted) needs to be taken with a pinch of salt.

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