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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 1034 - 10th 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 64 year old woman with shave biopsies of an irregular macule taken from the left scapula.

Case posted by Dr. Mark Hurt.

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Go to records June 2014

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

I favor lentiginous nevus, too. Nevertheless, as pigmented lesions on the back of an old man are always source of concern, immunostains are required to rule out definitively the possibility of melanoma in situ.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I can not perceive nests actually neither on H&E nor on Melan A, just lentiginous proliferation mainly along the tips and sides of rete ridges. The supra papillary plates r involved very focally with single non contiguous cells. I do think the lesion is an innocent simple lentigo. Waiting for the experts!!

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Guest Jim Davie MD

Guest Jim Davie MD

Posted

Agree with opinion of a hyperpigmented lentiginous junctional nevus. Depending on the overall architecture, this could alternatively qualify as a low-grade dysplastic nevus, as there is the hint (on low power) that this may be a poorly circumscribed lesion with some possible rete bridging, in the context of a clinical irregular macule and sun-damaged skin.
In my opinion, there is some tangential orientation that may be contributing to the increased (perception of) suprapapillary single melanocytes. No high grade atypia or significant pleomorphism, no significant epidermal attenuation or intraepidermal pagetoid scatter.

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