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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 998 - 21st April 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 an 84 year old white woman with excisions with margin exam of enlarging lesions, present five weeks, taken from A- the left medial malar complex.

Case posted by Dr. Mark Hurt.


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Guest Jim Davie MD

Posted

[size=4]In addition to melanoma, the differential would include: [/size]
SCC in situ, Merkel cell carcinoma, and sebaceous CA

This is a fast growing lesion. There is no significant melanin pigment or melanophages, equivocal squamous differentiation in some atypical cells, physaliferous vacuolation in malignant population, rapid growth, and high mitotic / apoptotic index. Stains will help differentiate.

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Mark A. Hurt MD

Posted

Here are some immunos:

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE998_Image%2007.jpg[/img]
[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE998_Image%2008.jpg[/img]

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Dr. Mona Abdel-Halim

Posted

Wao, beautifully demonstrated,, yet scary ,, poor old lady :-((

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Mark A. Hurt MD

Posted

My diagnosis: [url="http://www.ncbi.nlm.nih.gov/pubmed/15577682"]Melanoma with consumption of the epidermis[/url]

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