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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 1028 - 2nd June 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 74 year old man with a shave biopsy of a lesion on the right side of the scrotum.

Case posted by Dr. Mark Hurt.


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nick turnbull

Posted

Hmm..Heavily inflamed and spongiotic fbroepithelial polyp, with markerd parakeratosis with numerous neutrophils, reactive pagetoid dyskeratosis and verrucous xanthoma. I would wonder about trauma, infection (didn't see any fungi or bacteria), infestation (scabies), and contact/irritant dermatitis. Way off?

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Eman El-Nabarawy

Posted

Verruciform xanthoma.

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Arti Bakshi

Posted

Agree with Verruciform xanthoma.
There is evidence of keratinocyte necrosis in image 2 and 3, which is thought to be pathogenic in causing macrophage influx and xanthomatisation.

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Dr. Mona Abdel-Halim

Posted

Verruciform xanthoma

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Robledo F. Rocha

Posted

Verruciform xanthoma.

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Guest Tiberiu Tebeica

Posted

Verruciform xanthoma, which is fairly common on the scrotum.

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IgorSC

Posted

Nice Verruciform xanthoma.

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Mark A. Hurt MD

Posted

My diagnosis was verruciform xanthoma. I thought this was a beautiful and classic example.

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Guest Omobolade Obadofin

Posted

Classical Veruciform xanthoma. Nice case.

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Robledo F. Rocha

Posted

[quote name='arti bakshi' timestamp='1401709557']
Agree with Verruciform xanthoma.
There is evidence of keratinocyte necrosis in image 2 and 3, which is thought to be pathogenic in causing macrophage influx and xanthomatisation.
[/quote]
Very interesting this pathogenic hypothesis, Dr. Bakshi. I remember an ultrastructural study performed by [url="http://www.jaad.org/article/0190-9622(91)70117-K/abstract"]Balus et cols.[/url] which have suggested a transferation of lipid droplets from the cytoplasm of the melanocytes in the basal layer of the epidermis to the unknown-lineage foam cells that house in the in the dermis between rete pegs.

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