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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 2229 - 27 December 2018 Posted By: Iskander H. Chaudhry

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F78. Lesion right forearm.


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Proliferation of singly lying and nested melanocytes in the epidermis with cellular atypia and Pagetoid spread along with solar elastolysis in dermis point toward melanoma in situ.

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Alex-Ventura-Leon

Posted

Melanoma in situ.

The dermis looks slightly fibrotic.

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That´s not an easy case. It looks like Lentigo maligna, but I would look for previous melanocytic lesion excision. As Alex said above, there´s a fibrotic dermis that can be a clue to previous biopsy and maybe this is a recurrent nevus.

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Iskander H. Chaudhry

Posted

Dear All. Thank you for your comments. Yes the scar represents a previous excision of melanoma in situ so IgorSC's comment is very valid. The scar was re-excised as the melanoma in situ reached a margin and this is the re-excision. The differential of recurrent naevus was discussed at length but the degree of atypia and Pagetoid spread rendered a final diagnosis of residual melanoma in situ. 

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