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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 1901 - 011 Sept - Dr Limin Yu 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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56 yo F, left arm lesion.

Edited by Admin_Dermpath


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Alice Roberts

Posted

I'd have to go with Bowen's disease. May be pigmented Bowen's disease.

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Large cell acanthoma is a controversial entity and one opinion is that it's a variant of Bowen's !!! Sanchez YE. Am J Dermatopath 1988; 10: 197-208

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Sasi Attili

Posted

Find this very difficult. Not convinced of Bowen's. So will go with large cell acanthoma. 

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Dr. Richard Carr

Posted

I started with bowen's and moved to LCA. p16, Ki67 & p53 would usually sort this in most cases but favour LCA on the images here.

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Thank everyone for the insightful discussion. I considered both SCCIS and Large cell acanthoma. Knowing that LCA is a controversial entity (some believe it is a variant of lentigo or SK), I still favor it. The significance of LCA is not to diagnose SCCIS on lesions like this. 

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