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 2256 - 5 February 2019 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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25 year old female with lesion on chest

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Dr. Mona Abdel Halim

Posted

Combined banal and blue nevus?

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HENRY

Posted (edited)

I like to call it “deep penetrating nevus”. There is a small junctional component. The whole dermis is involved by the lesional cells which show no gradient or maturation phenomenon. The cells are arranged in a “Plexiform” pattern with elongated cords or oval nests of epithelioid monotonous melanocytes showing pale cytoplasm. Associated pigmented melanophages are present. In some sections, it shows growth of nevus fascicles along the eccrine glands. The stroma collagen appears undisturbed. Overall, it fits best with DPN.(though the lesion is transacted not shown the deeper aspect of the lesion)

Edited by HENRY

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vincenzo

Posted (edited)

12 hours ago, HENRY said:

I like to call it “deep penetrating nevus”. There is a small junctional component. The whole dermis is involved by the lesional cells which show no gradient or maturation phenomenon. The cells are arranged in a “Plexiform” pattern with elongated cords or oval nests of epithelioid monotonous melanocytes showing pale cytoplasm. Associated pigmented melanophages are present. In some sections, it shows growth of nevus fascicles along the eccrine glands. The stroma collagen appears undisturbed. Overall, it fits best with DPN.(though the lesion is transacted not shown the deeper aspect of the lesion)

Full agree!!!

 

HELLO MONA, WELCOME BACK! MISSED YOUR COMMENTS!

Edited by vincenzo

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Dr. Mona Abdel Halim

Posted

7 hours ago, vincenzo said:

Full agree!!!

 

HELLO MONA, WELCOME BACK! MISSED YOUR COMMENTS!

Missed you all :-) 

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Uma Sundram

Posted

Combined nevus. I like to think that there is more than one way to approach this problem. DPN vs combined nevus is all in the eye of the beholder. BAP1 is retained. Glad to see you again, Mona. You keep me honest. Hope to see you at LDS this year. 

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