Case Number : Case 1914 - 29 Sept - Dr Richard Carr Posted By: Guest

Dear All 

Richard has posted his diagnosis on:

Inflammatory Vitiligo or Hypopigmented Mycosis Fungoides?

The thick intrapapillary dermal collagen bands and some cytology always details make me favor HMF. But there is an odd atypical palisaded layer in basal epidermis: lymphocytes? Melanocytes? So many doubts...

Rete ridge hyperplasia with increased basal melanocytes with vacuolation in some. Few melanophages in dermis. Solar lentigo or PUVA lentigo

Solar Lentigo

With my very limited knowledge on non-inflammatory dermpath, this lesion looks melanocytic, immuno may highlight the true nature of junctional activites and upward spread which is very hard to appreciate on H&E.

I thought about the possibility of lentiginous dyspalstic naevus of elderly or lentiginous melamona (if one regard them separate). 

As Saman mentioned, I would be careful with the dx. Clinical impression is worrisome, there is a filiform continuous hyperplasia of melanocytes and the dermis has extensive solar damage.

Dr Richard Carr: Diagnosis 

Seborrheoic keratosis with basal clear cells. Case c/o Dr Philip Shapiro.

So I was barking up the wrong tree...Shame on me!