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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1724 - 5 January - 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: 40/M, lesion forehead.

Case Posted by Dr Arti Bakshi


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Admin_Dermpath

Posted

Beautiful images from Dr Arti Bakshi.

 

Happy New Year, Geoff Cross - DermpathPRO Projects

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Dr. Mona Abdel-Halim

Posted

What about panfolliculoma? I can see in the fifth image esinophilic THG indicative of matrical differentiation in addition to areas with hair germ differentiation (with papillary mesenchymal bodies), in addition to infundibular and trichilemmal keratinization?

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Robledo F. Rocha

Posted

2 hours ago, Dr. Mona Abdel Halim said:

What about panfolliculoma? I can see in the fifth image esinophilic THG indicative of matrical differentiation in addition to areas with hair germ differentiation (with papillary mesenchymal bodies), in addition to infundibular and trichilemmal keratinization?

I fully agree with you, Mona!

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vincenzo polizzi

Posted

When I see a trichofolliculoma-like  tumor, with trichoblastic and matrical epithelial components and an evident mesenchimal-body type stroma, I think of PANFOLLICULOMA, so I agree with Mona and the above. 

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Arti Bakshi

Posted

Apologies for the late reply...I have been on holiday with limited internet connection!

Yes, my d/d was TF and cystic panfolliculoma too. The panfollicular differentiation is quite well seen with follicular germinative cells with specific follicular stroma, inner root sheath differentaition with bright red trichohyalin granules and infundibular differentiation.

Both trichofolliculoma and panfolliculoma show panfollicular differentiation. Trichofolliculomas show a typical silhouette of central cyst like infundibulum with  vellus follicles radiating from it. Although panfolliculoma tend to be more solid and multinodular, cystic panfolliculomas show an architecture rather similar to TF. According to Kazakov, ''so called cystic panfolliculoma may in fact be a variant of Trichofolliculoma''. I think the distinction depends on greater dominance of immature germinative elements in PF as opposed to more advanced follicular diffrentiation in TF. Based on this, a cystic panfolliculoma was favoured in this case.

Thanks for all your comments.

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