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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 1718 - 28 December - Dr Hafeez Diwan Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Clinical History: 61 year-old female with left toe lesion.

Case Posted by Dr Hafeez Diwan


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Admin_Dermpath

Posted

Here is Dr Hafeez Diwan's final spot diagnosis case for the year.

 

Cheers, Geoff Cross - DermpathPRO Projects

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urmilapandey

Posted (edited)

thinking on the lines of nerve sheath tumour and perineurioma. benign mesenchymal lesion like a fibroma of tendon sheath or desmoplastic fibroblastoma also a possibility. would do S100, EMA, CD34, Smooth muscle actin and Desmin

Edited by urmilapandey

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Raul Perret

Posted

Due to topography we have to think in cellular digital fibroma (probably a variant of superficial acral fibromyxoma). As Urmila mentioned, I would still perform a pannel of immunos my main differential is neurofibroma (some mast cells seen in last picture).

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vincenzo polizzi

Posted

Superficial Acral Fibromyxoma, cellular type.

Wonder myxoid tissue is more than it looks, and there are some nice mast cells too!

I was thinking of a solid variant of angioleiomyoma, but it is too superficial, so favour SAF.

Sorry: errata corrige angiomyxoma with fibromyxoma!!!

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Raul Perret

Posted

2 minutes ago, vincenzo polizzi said:

Superficial Acral Angiomyxoma, cellular type.

Wonder myxoid tissue is more than it looks, and there are some nice mast cells too!

I was thinking of a solid variant of angioleiomyoma, but it is too superficial, so favour SAA.

Same thought at the same time dear Vincenzo

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Dr. Mona Abdel-Halim

Posted

First thought: superficial acral fibromyxoma

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Robledo F. Rocha

Posted

Yes, superficial acral fibromyxoma. Bland spindled cells with fascicular arrangement embedded in myxocollagenous vascular matrix with increased numbers of mast cells, tipically separated by a grenz zone from the epidermis (upper two images) and from the flat epithelium of the nail bed (bottom left image).

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Dr. Hafeez Diwan

Posted

I called this superficial acral fibromyxoma.

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Alice Roberts

Posted

Agree with superficial acral fibromyxoma (had similar one recently)

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urmilapandey

Posted

thanks  dr hafeez diwan for sharing this case, learnt a new entity today!

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