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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 923 - 6th January 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 a 67 year old woman with a shave biopsy of an irregular macule taken from the superior aspect of the right scapula

Case posted by Dr. Mark Hurt


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Guest Engin Sezer

Posted

Pigmented clonal seborrheic keratoses

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Guest Maria George

Posted

Take it easy Mark.Junctional nevus+milia+Seb.Keratosis.

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Junctional naevus (left) + reticulated seborrhoeic keratosis (right).

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Eman El-Nabarawy

Posted

Junctional nevus with seborrheic keratosis-like appearance of the overlying epidermis.

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Guest Ali Y. Hashim

Posted

[b]Clonal seborrheic keratosis[/b]

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Robledo F. Rocha

Posted

[font=arial,helvetica,sans-serif][size=4][color=#000000]Collision of junctional melanocytic nevus and reticulated seborrheic keratosis, a common association that seems [url="http://www.derm101.com/wp-content/uploads/dpc0202a09.pdf"]one of the two lesions have induced the other[/url].[/color][/size][/font]

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Guest Jim Davie MD

Posted

Pigmented seborrheic keratosis, with coexistent compound melanocytic nevus. (The pigment increase in the papillary dermal nest of bottom left photo hints that it is intradermal, in my opinion).

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Guest Romualdo

Posted

Lentiginous junctional melanocytic nevus.

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Guest Tiberiu Tebeica

Posted

Collision between compound melanocytic nevus with dysplastic features / Clark's nevus and seborrheic keratosis

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Mark A. Hurt MD

Posted

Here is Melan-A applied to the lesion. Does it alter your diagnosis?


[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE923_Image%2007.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE923_Image%2008.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE923_Image%2009.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE923_Image%2010.jpg[/img]

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Eman El-Nabarawy

Posted

Lentiginous junctional melanocytic nevus with overlying epidermal seb k like features.

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Dr. Mona Abdel-Halim

Posted

Just arrived home... Lentiginous junctional nevus in conjunction with a reticulated seb K.

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Mark A. Hurt MD

Posted

My diagnosis was a junctional lentiginous melanocytic nevus in conjunction with a seborrheic keratosis. I interpreted the "dermal" nests as phenomena out of the plane of sectioning but probably connected to the epidermis, but I understand how they can be interpreted as dermal.

Although this case might seem straightforward, I have seen a number of melanomas in situ that have colonized seborrheic keratoses, so I urge everyone to be on their guard for that phenomenon. Helpful in this is case is the lack of confluence of melanocytes at the dermoepidermal junction. There is consistent sparing of the suprapapillary plates as well.

Whether the nevus has an induction effect on the epidermis to produce this phenomenon is anyone's guess, but I think it is possible, as SK-like changes are fairly common in congenital melanocytic nevi, so perhaps that is a clue to some type of causal association.

Thanks, everyone, for participating.

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