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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 2872 - 09 July 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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F40. Yellow plaque on forehead that developed an area of ulceration. ?inflammation ?tumour.


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Eman El-Nabarawy

Posted

Nevus sebaceous with follicular induction and associated BCC (favored over trichoblastoma for immunos).. Not sure of the top left image, Does it contain trichoblastoma on the right side!..

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Dr. Richard Carr

Posted

Thanks. There is definitely naevus sebaceous and superficial trichoblastoma (with prominent reactive Merkel cells). There is a BCC-like nodule (epithelial predominant for CD10 lacking reactive Merkel cells) that could be a nodular trichoblastoma or a BCC - I can't tell the difference if I'm honest but the p16 and p53 are giving a "benign" pattern. I've repeatedly had this problem over the years and I can say I've never seen a deeply / irregularly invasive or infiltrative typical BCC in naevus sebaceus so my gut feeling is these are benign lesions (best excised with clear margins).

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NS with Trichoblastoma. I also don't consider those as BCC.. but they do have a spectrum changes. stains in my hand not helping much in this scenario.

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