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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 2887 - 30 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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M45. Shoulder, ?melanoma


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A difficult regressed melanocytic lesion...probably melanoma. It’s asymmetric. 

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Eman El-Nabarawy

Posted

Are the figures 7th and 8th of the same case? What r the labeling of the immunos?

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Dr. Richard Carr

Posted

I wanted you to guess the IHC but the left two are p16 and the right two are melanA. Yes all images are the same case but agree that's important to check!

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Dr. Richard Carr

Posted

Images 7th and 8th and IHC were posted later but with only one comment at that point it sort of defeats the idea a little.

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Sorry. I’m late. Fastweb has been out of order for two days in my town. 
how about a melanoma in situ overimposed in a BCC? Prognostically not too much dangerous? 

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Zuli Baharom

Posted

Superficial BCC with and regressed melanocytic lesion.

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Eman El-Nabarawy

Posted

Superficial BCC colonised by melanocytes(denderitic) adjacent to melanoma in regression..

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Dr. Richard Carr

Posted

We concluded a pigmented BCC with regression could easily and more likely account for the pattern of superficial tumoural melanosis rather than a BCC and a regressed superficial melanoma. This would be Occam's razor solution i.e. keep it simple: 

Definition of Occam's razor

 

: a scientific and philosophical rule that entities should not be multiplied unnecessarily which is interpreted as requiring that the simplest of competing theories be preferred to the more complex or that explanations of unknown phenomena be sought first in terms of known quantities.

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Dr. Richard Carr

Posted

Forgot to say thank you to Dr Domenico Mesiano for sharing this case. 

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Eman El-Nabarawy

Posted

Gorgeous..And logic.. Thank u for this teaching case..

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