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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 1976 - 28 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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21 year old male with scalp lesion.


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Dr. Richard Carr

Posted

After 4 hours I'd normally have expected a few responses unless the seasions cheer has befuddled a few people. I am somewhat befuddled myself by this case. How about MHotS.

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Burnt out scarring alopecia. No sebaceous glands, not much of inflammation. Collagen appears thickened and hyalinized but epidermis is not suggestive of morphea.

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The history is a scalp lesion. Is it a lesion or alopecia?

I see vessels and multinucleated giant cells. If on the lower extremities, I might think of multinucleate cell angiohistiocytoma. But this is on the scalp. So need clinical history to see what we are dealing with.

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vincenzo polizzi

Posted

What about Interstitial Granuloma Annulare?

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Uma Sundram

Posted

Happy New Year everyone! I think the season has affected everyone, and my apologies for this difficult case. The patient indeed had a history. Solitary lesion on the scalp, 21 year old male, with an orchiectomy specimen that came out soon thereafter. A very unusual case of metastatic choriocarcinoma. I have only seen one other case before! I admit the photographs are suboptimal, but it was not a generous biopsy. I thought one possible clue was the history (as I received this completely blinded): Young patient, solitary lesion on the scalp, always makes me think of something bad. 

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Dr. Richard Carr

Posted

Funny as a solitary lesion on the scalp at this age would have had cancer very low down! Well done Uma!

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