Case Number : Case 1967 - 13 Dec 2017 Posted By: Iskander H. Chaudhry

Please Dr Iskander what’s the case 1948 diagnosis?

A well circumscribed and symmetrical lesion, without atypical features. Not expansive growth pattern. I think of acral type nevus. 

Benign for me too, in the lines of Spitz

Acral naevus with site related atypia...at worst mildly dysplastic naevus.

The dermal component is naevic and matures with depth. Is there a dermal mitosis in the last image?? Even if it is, wouldnt change my diagnosis, but would have a good look around for any more mitoses.

There is atypia, with 'nevoid' type cells and prominent nucleoli near the base. However, the lesion seems small, the patient is relatively young, and it's an acral lesion. I am leaning toward an acral nevus, but would follow over time and have the caveat that these are difficult lesions and are often seen by multiple consultants. It appears excised and I'm not sure I would send them back.

Considering the site, age, fits with acral naevus.

These are difficult cases

Acral Spitz naevus. Looks out "watchful waiting".

Acral naevus with spitzoid features, benign.

Agree with Acral nevus

Acral nevus

Many thanks every one. We called this an acral naevus with mild atypia!