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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 1238 - 23 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 52-year-old white woman with a punch biopsy of a lesion on the right fourth digit. Clinical Diagnosis: R/O foreign object.

Case posted by Dr Mark Hurt
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Go to records March 2015

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Guest Jim Davie MD

Guest Jim Davie MD

Posted

[color=#111111][font=Arial, Helvetica, sans-serif][size=3]Porokeratotic eccrine ostial and dermal duct nevus (PEODDN).[/size][/font][/color]

[color=#111111][font=Arial, Helvetica, sans-serif][size=3]Cornoid lamella involving an eccrine duct (acrosyringium) is a key finding for PEODDN, and helps differentiate from DDx of punctate palmoplantar keratoderma. This would be an unusual presentation if showing up as a solitary lesion de novo in an adult..was it solitary? [/size][/font][/color]

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Looks like it is on the palmar surface of the digit, Could it be keratosis punctata of the palmar crease? It can be centered on an acrosyringium. Although delayed onset of PEODDN has been reported, it is usually not a solitary lesion. Could it be an unusual punctate porokeratosis?

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Arif Usmani

Arif Usmani 17

Posted

Porokeratoma ([color=#000000][font=arial, helvetica, clean, sans-serif][size=2][url="http://www.ncbi.nlm.nih.gov/pubmed/18043046#"]Am J Surg Pathol.[/url][/size][/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif][size=2] 2007 Dec;31(12):1897-901[/size][/font][/color])

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I thought of porokeratoma but in textbooks it says that it shows multiple confluent cornoid lamellae??

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Arif Usmani

Arif Usmani 17

Posted

There is also a case report of a solitary PEODDN.
[color=#000000][font=arial, helvetica, clean, sans-serif][size=2][url="http://www.ncbi.nlm.nih.gov/pubmed/?term=solitary+peoddn#"]Am J Dermatopathol.[/url][/size][/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif][size=2] 2009 Aug;31(6):582-6. doi: 10.1097/DAD.0b013e3181a09b62.[/size][/font][/color]

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