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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 1541 - 20 May 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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?Actinic keratosis

Dr Richard Carr

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Dr. Mona Abdel-Halim


Yes, large cell acanthoma

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Guest Arash Daryakarr


large cell acanthoma

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Dr. Richard Carr


My report:

Slightly pigmented large cell acanthoma. No frank dysplasia.


I agree from personal experience that they often appear to be closely related to solar lentigo (all be it the "keratosis" outweighing the pigmentation).  The point is they are rather subtle and nice to have in your diagnostic armamentarium. I have always discussed with dermatology colleagues that solar lentigo is on a spectrum with thin seborrhoeic keratosis (and not a lentiginous melanocytic proliferation at all). In that sense LCA and thin seborrheoic keratosis are not really alike as the former is composed of larger and paler keratinocytes without significant cellular hyperplasia compared with the latter. Perhaps LCA is worth keeping as a separate entity.


Slightly radical thought, perhaps solar lentigo should be renamed pigmented LCA! and reported as follows:


Pigmented large cell acanthoma (formerly known as solar lentigo).

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