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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 2536 - 26 March 2020 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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42F, suspected cyst on scalp.


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Krishnakumar subramanian

Posted

eccrine hidrocystoma

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Cem Leblebici

Posted

Do we only observe the basal layer of trichilemmal cyst with suprabasal seperation?

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Saleem Taibjee

Posted

Yes, Cem is spot on. This is a great and notorious pitfall, in which suprabasal separation of the pilar (tricholemmal) cyst wall (presumably at the time of surgery) leaves a remnant which can produce a mimic of hidrocystoma. This is a particularly impressive example. The clue is in the first image, where at the bottom of the field I included more typical pilar cyst at the edge. Below I include other parts of the section which I had deliberately omitted in the first set of images.

Arrowed image.jpg

16023_0.6x.jpg

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16023_20.0xb.jpg

 

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Very nice case!!! Good Job, Cem!

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