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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 1961 - 5 Dec 2017 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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67 y old male with penile lesion.


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Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB) if clinically correlated

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Admin_Dermpath

Posted

Dear All Please note Dr Bakshi has posted immuno on her case:

 

 

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Admin_Dermpath

Posted

Dear All The immuno has been now added to Dr Carr's case:

 

 

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LSC is not commonly seen on the penis, it's rather common on the scrotum

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Dr. Richard Carr

Posted

PKMB sounds good!  I've not heard of it. I also considered the possibility of an epidermal naevus in addition to the other suggestions above.

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Uma Sundram

Posted

Thank you for all of the thoughtful and insightful comments. The patient also had patches on his scrotum and has a background of lichen sclerosus (BXO). We noted the presence of this unusual verrucous lesion, which did not look like typical VV, and the clinician was concerned about malignancy. Our biggest concern was differentiated PeIN but it was agreed that atypia typical of that lesion was not present here. HPV was negative. Certainly PKMB is part of the differential histologically, although the typical micaceous scale described with that entity was not present in this case.

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