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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 2644 - 25 August 2020 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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84 year old male with lesion on left shoulder.


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Richard Logan

Posted

Deep penetrating naevus.  Betacatenin?

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Dr. Mona Abdel-Halim

Posted

In this age, I would not like to miss a blue nevus like metastasis of a melanoma especially with the foci of lymphoid infiltrate at the periphery of the lesion?

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18 hours ago, Eman El-Nabarawy said:

What about PEM?

Yes. Dendritic cells + epithelioid pigmented cells + melanophages. 

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Krishnakumar subramanian

Posted

cellular blue nevus

 

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Uma Sundram

Posted

Yes, we thought of both CBN and PEM. We were less concerned about melanoma, but recommended complete excision.

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Dr. Richard Carr

Posted

S100 can be useful for this differential. Blue naevi are usually weak/negative. I'd expect most PEM's to be strongly positive although you might need a Giemsa counterstain or a red chromagen.

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