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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 1754 - 16 February - Dr Arti Bakshi Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Clinical History: 20/F, 3cm pedunculated hyperkeratotic lesion back of thigh since childhood.

Case Posted by Dr Arti Bakshi


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Admin_Dermpath

Posted

To mark my favourite middle daughter, Jenny's 25th Birthday, Dr Arti Bakshi has a great case for you all.

 

Geoff Cross - DermpathPRO Projects

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Arti Bakshi

Posted

many happy returns to Jenny!  If I'd known, i would have put in something much nicer than these warty bits of skin!! 

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Raul Perret

Posted

I thought this is a warty lesion with papillomatosis, acanthosis, epidermolytic hyperkeratosis and foci of SCAP. So as there is a combination of lesions I thought of naevus sebaceous. 

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The location is atypical, but my diagnosis is also Nevus sebaceous with Syringocystadenoma papilliferum.

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vincenzo polizzi

Posted

This is an exophytic epidermal proliferation with papillated  structures and columns of hyperkeratotic mass associated with    cystic invaginations typical of syringocystoadenoma papilliferum.How about an "apocrine acrosyringeal keratosis associated with syringocystoadenoma papilliferum?

https://www.ncbi.nlm.nih.gov/pubmed/?term=Yamamoto M[Author]&cauthor=true&cauthor_uid=10735969

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Dr. Mona Abdel-Halim

Posted

Happy BD to Jenny :-))

SCP 

back ground apocrine acrosyringeal keratosis is a lovely suggestion by Vincenzo :-)

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Robledo F. Rocha

Posted

Site is unusual, but I agree with my colleagues. This is a nevus sebaceus of Jadassohn with verrucous acanthosis of the epidermis and postpubertal development of syringocystadenoma papilliferum.

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Arti Bakshi

Posted

Yes, I went for SCAP too with verrucous acanthosis and raised possibility of Naevus Sebaceous. Agree, site is ODD!!

Kazakov mentions this as a specific variant of SCAP (pg 65) ie. Viral wart like changes in SCAP or Verrucous SCAP and many of these are associated with naevus sebaceous. Apparently the surface epidermal changes not just mimic a vral wart but HPV DNA has been detected by PCR and ISH in some lesions leading to reports of condyloma acuminatum in association with SCAP. https://www.ncbi.nlm.nih.gov/pubmed/7864300.

Vincenzo's suggestion is also interesting and probably represents the same spectrum.

 

 

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