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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 979 - 25th March 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 44 year old woman with an excision with margin exam of an enlarging lesion, present one year, taken from the midline lower lip.

Case posted by Dr. Mark Hurt.


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Eman El-Nabarawy

Posted

Leukoplakia!! without dysplastic changes.

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I see basal hyperpigmentation, favor labial melanotic macule.

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Dr. Mona Abdel-Halim

Posted

First impression, labial melanotic macule. Increased basal pigmentation with no melanocyte hyperplasia.

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Robledo F. Rocha

Posted

Due to broad rete ridges and to keratinocytes with glicogenated cytoplasm that appear larger than control keratinocytes of lateral margins, I think this is large cell acanthoma, a variant of labial lentigo in my opinion.
[url="http://www.derm101.com/dpc/january-2014-volume-4-no.1/large-cell-acanthoma-a-debate-throughout-the-decades/"]http://www.derm101.com/wp-content/uploads/dp0401a05.pdf[/url]

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Mark A. Hurt MD

Posted

Here are a few more photos. I'll post the answer much later today.

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE979_Image%2005.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE979_Image%2006.jpg[/img]

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Eman El-Nabarawy

Posted

Oral melanocytic nevus. The margin shows benign lentiginous melanocytic hyperplasia with epithelial hyperplasia.

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Dr. Mona Abdel-Halim

Posted

I think there is no actual melanocyte hyperplasia highlighted by Melan A. This is just the effect of the increased melanin content of the basal layer, highlighted by Masson Fontana. I am still thinking of labial melanotic macule.

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Mark A. Hurt MD

Posted

My diagnosis was labial melanotic macule. I agree with Dr. Mona that there is hyper pigmentation of the basal layer but not a melanocytic proliferation as such. Note also the sparing of the suprapapillary plates, which is a very good sign for labial melanotic macule.

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