Jump to content
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 2312 - 26 April 2019 Posted By: Dr. Richard Carr

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

M40. Back. ?Giant comedone. c/o Dr Saleem Taibjee, Dr Corrado, Dr Florin Dobritoiu


  Report Record

User Feedback


Well, I do not know exactly how to give a name for this, but it seems to be a trichilemoma associated with a proliferating trichilemal tumor in the dermis. In the last figure on the right edge, we can see some follicular germ formation, so maybe this is all part of a small nevus sebaceus of jadassohn.

Share this comment


Link to comment
share_externally

Very difficult for me. As Igor said, there is something trichilemmoma-like and something germ-like ( ?matrichal ) and inner root sheath differentiation also....PANFOLLICULOMA???

Share this comment


Link to comment
share_externally

Anil Patki

Posted

Central keratin filled crater with bulbous lobules emanating from it. I think that it's a pilar sheath acanthoma

Share this comment


Link to comment
share_externally

Meenakshi Batrani

Posted

I agree with Pilar sheath acanthoma

Share this comment


Link to comment
share_externally

vincenzo

Posted (edited)

Yes. I was wrong. PSA is a better option. But...I was also thinking about a extrascalp proliferating trichilemmal cyst. 

Edited by vincenzo

Share this comment


Link to comment
share_externally

Victor Delgado

Posted

I think this is a pilar sheet acanthoma. There is ditated infundibulum with broad acanthotic epithelial projections. Thanks for sharing.

Share this comment


Link to comment
share_externally

Krishnakumar subramanian

Posted

pilar sheath acanthoma

Share this comment


Link to comment
share_externally

Dr. Mona Abdel-Halim

Posted

My first thought was pilar sheath acanthoma too

 

Share this comment


Link to comment
share_externally

Dr. Richard Carr

Posted

My first thought was also pilar sheath acanthoma (having the infundibular component superficially and outer root sheath component in the deeper aspect) but based on the additional presence of the follicular bulbs and papillary mesenchymal bodies I settled on panfolliculoma. Although we are not seeing matrical or typical inner root sheath differentiation here. Of course there is an overlap with trichoblastoma that also shows papillary mesenchymal bodies and hair germinative differentiation and occasionally also inner root sheath and matrical differentiation and frequently infundibular-cystic structures. I guess it's a little academic as it's benign in either case. Pilar sheath acanthoma are one of the less common adnexal tumours but panfolliculoma for me is exceedingly rare and as I say I'm not sure it's worth separating it from trichoblastoma. I see PSA does get a spot in the 4th WHO Skin Classification but panfolliculoma (15 cases in the literature according to Kazakov's book) is not mentioned.

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...