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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 2075 - 21 May 2018 Posted By: Limin Yu

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Lesion on a 65 year old male back.


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Raul Perret

Posted

Trichoepithelioma (racemiform trichoblastoma)

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vincenzo polizzi

Posted

Difficult case of adnexal cutaneous tumor. It looks like a trichifolliculoma, but my first spot is of INFUNDIBULOCYSTIC BCC. There is an epithelial stromal retraction and a myxoid stroma. 

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Mani Makhija

Posted

pigmented infundibulocystic (organoid) basal cell carcinoma. 

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Arif Usmani

Posted

IFC BCC vs Basaloid follicular hamartoma 

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Dr. Richard Carr

Posted

The best diagnosis in BCC (infundibulocystic/TE-like). Remember TE tend to have about 50% stroma c/w epithelium this case is more like 70:30 infavour of epithelium. Also no papillary mesenchymal cells to my eye in these images. My "limited" IHC of choice CD10 (epithelium predominant supports BCC while stromal predominant supports TE) and CK20 (30% of TE have numerous reactive dendritic Merkel cells). Also at this age you will see probably 20+ TE-like BCC for every TE.

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Limin Yu

Posted

Thank everyone for the insightful discussion. It is a "tough" case, both TE and BCC are in the differential diagnosis. My vote is that this is a BCC (infundibulocystic growth pattern).

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