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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 2992 - 24 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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5. Longstanding cystic swelling close to midline on back. Previously discharging and infected.


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Cyst wall contains cells with coarse keratohyaline granules and koilocytes. I think that this is a verrucous cyst.

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Richard Logan

Posted

On 24/12/2021 at 13:45, Anil Patki said:

Cyst wall contains cells with coarse keratohyaline granules and koilocytes. I think that this is a verrucous cyst.

Agree.  Cytopathc changes not as marked as Richard Carr's previous example:  Case 2104  29th June 2018

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Dr. Richard Carr

Posted

Thanks all. Agree with verrucous cyst, rather hybrid infundibular-tricholemmal. p53 and Ki67 are concordant peripheral patterns as expected in benign or reactive lesions. p16 show a low mosaic pattern which is probably normal for the sun-protected location deep in the dermis. The epidermal changes here reminded me of dermatofibroma but I was unconvinced by a dermal component suggestive of the latter.  Seasonal greetings and best wishes for the year to come. 

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Thanks a lot, Richard, for your very educative and useful tips. Happy new year. 

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