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?

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Case Number : Case 2174 - 9 October 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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65 year old woman with lesion on right cheek.

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User Feedback


John Zhang

Posted

I can certainly see why the above comments considered poroma. However I think in poroma the amount of cytoplasm is usually more abundant and more eosinophilic. And the necrosis en mass in poroma is usually sharply demarcated unlike the granual transition in this case. To me this case shows basaloid cells as seen in follicular germs, and abortive hair papilla. My spot is pilomatricoma.

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John Zhang

Posted

Also keep in mind that basal cell carcinomas can have areas of matrical differentiation. So make sure this is not the edge of a basal cell carcinoma.

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vincenzo

Posted

Something pilomatrical benign lesion. But I don't know what to call this.

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Dr. Richard Carr

Posted

Looks matrical with inner root & hair cortex differentiation How about a hair cortex comedo with matrical differentiation? I like these little challenges. See cases 837 and 1973.

Regards from Sau Paulo, Brazil where I'm attending the ISDP (later in the week) and have a couple of cases in the self assessment. Please do say hello if anyone is attending.

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Uma Sundram

Posted

Believe it or not, hair cortex comedo with matrical differentiation is the best fit. I had also thought of the world's smallest pilomatricoma but really like Richard's suggestion. The lesion was tiny and there was no BCC anywhere else. Panfolliculoma is also a good idea; but really this was it - there were no other proliferations in the biopsy. Have fun in sau paulo Richard! 

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Dr. Richard Carr

Posted

Hey fantastic - I still get a huge kick out of this site and already met a few Dermpathpro supporters including IgorSC and Robledo Rocha (who gave a great case presentation on Lobomycosis - I failed to "spot" annoyingly but should get it next time thanks to him).

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