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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 2977 - 3 December 2021 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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F80. Left lower leg. 8 years history of an erythematous scaly lesion on left leg. 23mm x 20mm erythematous plaque. DD: Bowen’s disease ? seb keratosis.


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Looks like an atrophic SK with overlying bowenoid changes. 

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Meenakshi Batrani

Posted

Appear like actinic keratosis, although there is no parakeratosis. 

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Richard Logan

Posted

How about annular lichen planus?  There is hypergranulosis at either end of the biopsy, with atrophy in the middle.

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Dr. Richard Carr

Posted

I favoured a rather thin and atrophic pattern of seborrhoeic keratosis. p16 is nice mosaic and p53 and Ki67 show a concordant peripheral graded pattern typical for benign lesions and reactive hyperplasia. The subsequent curettage showed a bland hyperkeratosis, no dysplasia. 

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