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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 1576 - 11 July 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 60 year old white woman with a shave excision taken from the right lower back.

Dr Mark Hurt


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Raul Perret

Posted

My interpretation of this lesion is that we have a displastic compound nevus (mildly to moderately atypical) on the left of the image that transitions to a melanoma in situ on the right of the image. I imagine a MELTUMP would come to the discussion here but for me the overall difference of architecture, large expansile nests on the right part of the lesion, massive compromise of the adnexae (mainly sweat ducts), size of the lesion alotgether with the topography and age of the patient makes me favour melanoma in situ + dysplastic nevus

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vincenzo polizzi

Posted

I see 3 combined contiguous melanocytic lesions: an intradermal nevus ( Far Left ), a compound dysplastic nevus ( Left/Medium ), a melanoma in situ ( Right )...agree with Raul.

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Nitin Khirwadkar

Posted

Agree with the comments above. Moderate and severe dysplasia, with occasional foci concerning for in-situ change.

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Mark A. Hurt MD

Posted

My diagnosis was as follows:

 

SKIN, RIGHT LOWER BACK , SHAVE EXCISION :

-- MELANOMA, in conjunction with melanocytic nevus (pT1a)

- Breslow measurement, 0.34 mm

- Clark level, II

- No ulceration

- No mitotic figures identified in the dermal component

COMMENT: The lesion is present in the peripheral surgical margin. 

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