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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 1996 - 30 Jan 2018 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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50 year old woman with 0.7 mm lesion on tip of nose. What are your management recommendations?


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User Feedback


Tricholemmal horn and cyst. Conservative excision should be enough

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based on the last image would consider a desmoplastic trichilemmoma

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I like desmoplastic trichlilemmoma. Definitely desmoplastic

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Dr. Richard Carr

Posted

Tricholemmoma. I've seen one case recur (must have seen >100 cases by now) but I think watch and wait is reasonable. It's one of the most commonly missed diagnoses in my experience and occasionally over-called.

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Dr. Richard Carr

Posted

Forgot to say I've neither seen nor heard of malignant transformation.

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Uma Sundram

Posted

Yes, desmoplastic trichilemmoma. I did recommend watch and wait. Never seen these go bad; am not sure I even remember a recurrence, actually.

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