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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 1428- 14 December Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)
Case History: The patient is a 77 year old man with a shave biopsy of a pearly telangiectatic papule on the left nasal sidewall.

Case posted by Dr Mark Hurt
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  Report Record
Go to records December 2015

User Feedback


IgorSC

I think this is some kind of morfologyc variant of intradermal melanocytic nevus with pseudo-physalipherous cells. In a younger patient my first hypothesis would be intradermal Spitz nevus.

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Raul Perret

Raul Perret 262

Posted

Me I was thinking more of a neuroid variant of fibrous papule. I agree that the nuclei and architecture of cells makes think of nevus. Would consider doing s100, factor XIIIa and cd34 

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I think this is just a fibrous papule of the nose with the rare feature mentioned in Weedon's Skin Pathology in which there are numerous fibroblasts/histiocytes/dendrocytes with clear vacuolated cytoplasm embedded in dense sclerotic and hyalinized stroma. The clinical fits very well.

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Nitin Khirwadkar

Nitin Khirwadkar 63

Posted

Would favour a fibrous papule. Would do S-100 to rule out a naevus variant, and a cytokeratin.

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Guest Romualdo

Guest Romualdo

Posted

Agree with Raul and Mona: clear cell variant of fibrous papule of the nose.

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Guest

Agree with fibrous papule with clear cells.  I think Dr Hurt posted a similar case a few months ago. 

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Sasi Attili

Sasi Attili 85

Posted

My first thought was a cellular variant of a fibrous papule. Obviously would not sign this out without immunos- S100, Fac XIIIa at least....

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