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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 2722 - 11 December 2020 Posted By: Dr. Richard Carr

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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M19, Scalp. 7mm changing pigmented lesion ?Naevus ?MM


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Dr. Richard Carr

Posted

20 views and no comments (apart from this one)

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I think there is maturation in this composite melanocytic lesion. The intraepidermal growth shows some basal spreading, but not Pagetoid or epidermal destructive consumption. So my spot is Atypical/Dysplastic Nevus

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I think this is a combined nevus, maybe a BAP1-inactivated nevus. It would be nice to see BAP1 and BRAF ihq in this lesion.

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58 minutes ago, IgorSC said:

I think this is a combined nevus, maybe a BAP1-inactivated nevus. It would be nice to see BAP1 and BRAF ihq in this lesion.

Usually the Bap1 negative cells, as I know, are large epithelioid cells, and intradermal nodule forming. But I’m happy to share the same benign suggestion with Igor. 

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Meenakshi Batrani

Posted

I am also not in favour of melanoma. Atypical/dysplastic nevus or may be BAP1 inactivated. 

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Dr. Richard Carr

Posted

Case c/o Dr Brinder "Buzz" Chohan.

My interpretation: Many thanks for the opportunity to review this case. This is a highly junctionally active compound lesion
with slightly enlarged type A melanocytes. Overall relatively good symmetry. Nice chequer board p16 throughout and minimal Ki67 nuclear proliferation. This is a special site naevus with some architectural atypical features as described in younger individuals on the scalp.
Excision appears complete with appropriate margins.

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Victor Delgado

Posted

Compound melanocytic nevus, special site.

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On 14/12/2020 at 07:58, Dr. Richard Carr said:

Case c/o Dr Brinder "Buzz" Chohan.

My interpretation: Many thanks for the opportunity to review this case. This is a highly junctionally active compound lesion
with slightly enlarged type A melanocytes. Overall relatively good symmetry. Nice chequer board p16 throughout and minimal Ki67 nuclear proliferation. This is a special site naevus with some architectural atypical features as described in younger individuals on the scalp.
Excision appears complete with appropriate margins.

Agree. Thanks Dr Carr.

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Scalp nevus can be as "striking" as though "ear" nevus.

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