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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 1640 - 7 October 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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F25. Lump thigh. c/o Dr Alex Kitchen. H&Ex8

Case Posted by Dr Richard Carr


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User Feedback


Admin_Dermpath

Posted

A really pretty set of images to wrap the week off. I hope that it isn't for something really nasty.

 

Cheers, Geoff Cross

AV and Data Limited - DermPathPro Projects

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vincenzo polizzi

Posted

A post-inflammatory melanosis is my first thought...but not sure...

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Nitin Khirwadkar

Posted

Epidermal acanthosis, hyperkeratosis and increased basal pigmentation, along with pigment incontinence within the superficial dermis. Possible, pulling up of the fat. I am not sure what this is, and how to explain a lump.

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Dr. Mona Abdel-Halim

Posted

I find the clinical description as lump a bit odd !!
I am worried about the third and last images, as if there is subtle Bowen or maybe melanoma in situ
Melan A, Ki67??

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Arti Bakshi

Posted

Like Mona's suggestion of a subtle (pigmenetd) Bowens! I think the melanocytes are probably fine. Image 3 and 6 do show disordered maturation of keratinocytes and subtle atypia (particularly if one compares with normal adjacent epidermis in other images). p53 and Ki67 needed.

Not sure how this ties in with lump on thigh, though!!

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Dr. Mona Abdel-Halim

Posted

I think Dr Carr is still hiding the images of the real lump and showing us only the margins now !!!

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Dr. Mona Abdel-Halim

Posted

My suspicion was correct, Bowen, pigmented type as Arti said. But still did not know why lump??!!!

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Nitin Khirwadkar

Posted

Definitely points towards Bowen's. Spent too much time trying to find a lump, and missed the epidermal atypia.

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Dr. Richard Carr

Posted

Unfortunately the colleagues who put the cases up sent you a curve ball by giving you the exact same history to this Monday's case - surprised none of you spotted that error!.


The correct history was as follows:

F60. Grey area on vulva, very itchy!
Diagnosis: Subtle undifferentiated VIN & (about as subtle as it gets so well done Mona for; questioning the stated history!).

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