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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 2145 - 29 August 2018 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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35 year old female lesion on arm ? MM

Edited by Admin_Dermpath


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Krishnakumar subramanian

Posted

nodular amelanotic melanoma

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Type A Nevus.

Testing for BAP1 loss will be of interest.

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Dr. Mona Abdel-Halim

Posted

BAPOMA is my first impression

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Admin_Dermpath

Posted

Dr Chaudhry response:

BAPoma: it lacks the 2 cell population, is not really polypoid and the cells are not quite right.

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Asymmetric and nodule-expansive. I think this is a small cell nodular melanoma.

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vincenzo

Posted (edited)

Please Dr Chaudry, what's the diagnosis of case 2125?

Edited by vincenzo

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Admin_Dermpath

Posted

Dr Chaudhry's response:

The lesion showed: no loss of BAP1 expression by IHC. HMB45 stained the upper part of the lesion and Ki67 was 20% in the same area (upper part). This was a difficult case to characterise but after several opinions it was felt the junction was definitely in situ melanoma and on balance the entire lesion was a malignant melanoma and should be treated as such. 

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