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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 950 - 12th February 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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65 year-old female with pink papule on the wrist.


Case posted by Dr. Hafeez Diwan.


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Guest Maria George

Posted

Agree.Some may consider pleomoephic fibrom , sclerotic fibrom and dermatofibroma are different spectrum of the same condition.

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Guest Hazem Hamed

Posted

Sclerotic perineurioma for EMA is my first thought. Then would agree with the above differential if EMA comes negative.

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Mark A. Hurt MD

Posted

Agree, sclerotic fibroma. Sometimes this is associated with Cowden's syndrome.

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Guest Jim Davie MD

Posted

Agree with Sclerotic fibroma.
- Clinical history of a solitary pink papule is a good fit.
- There is a "plywood" pattern of fascicular thick keloidal collagen bundles with prominent clefting artefact, sparse scattered oval to stellate cells (some with multinucleation), showing bland nuclear features; the latter finding helps differentiate this from the high-grade nuclear pleomorphism and atypia of a pleomorphic fibroma. The epidermis is attenuated, with absence of the psoriasiform acanthotic changes and/or basaloid features frequently seen in superficial dermatofibromas.

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Robledo F. Rocha

Posted

Yes, s[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]clerotic fibroma.[/size][/font][/color]

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