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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 1452- 18 January Posted By: Mark A. Hurt MD

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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Case History: The patient is a 76 year old man with a shave biopsy of a 4 x 4 mm thin, reddish brown papule taken from the left lower mid back.


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Raul Perret

Posted

Makes me think of acantholytic acanthoma with an associated intradermal nevus

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biswanath behera

Posted

suprabasal cleft, row of tomb stone appearance, acantolytic cells with areas showing dilapilated brick wall appearance with dyskeratotic cells.

 

if solitary lesion- acantholytic acanthoma

if multiple lesions- Hailey -Haily type of Grover's disease

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Nitin Khirwadkar

Posted

Acantholytic acanthoma. Image 1 and 3 certainly shows what looks like an IDN.

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vincenzo polizzi

Posted

Agree with Acantholytic Acanthoma

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Guest Romualdo

Posted

Acantholytic acanthoma and associated intradermal nevus.

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Mark A. Hurt MD

Posted

Congrats to everyone!

 

SKIN, LEFT LOWER MID BACK , SHAVE BIOPSY :

-- ACANTHOLYTIC ACANTHOMA, TRAUMATIZED, WITH SUPERFICIAL CONGENITAL

MELANOCYTIC NEVUS

COMMENT:  Acantholytic acanthomas are different from warty dyskeratomas and epidermolytic acanthomas in that the acantholytic acanthomas lack epidermolysis and lack corps ronds and grains.  The largest series of these lesions was published by Brownstein in 1988, and he made the point that correlation should be done to ensure that the patient does not have a specific blistering disease such as pemphigus or Hailey-Hailey disease.

 

Brownstein MH. Acantholytic acanthoma. J Am Acad Dermatol. 1988 Nov;19(5 Pt 1):783-6. PubMed PMID: 2461398.

 

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