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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 2831- 13 May 2021 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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63F punch biopsy right upper back: Exquisitely tender spot ?neuroma ?BENGAL


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vincenzo

Posted

Palisades Encapsulated Neuroma. 

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Richard Logan

Posted

Looks leiomyomatous to me.

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Meenakshi Batrani

Posted (edited)

Looks more like a traumatic neuroma to me.

Edited by Meenakshi Batrani

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Krishnakumar subramanian

Posted

plexiform neural tumor

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vincenzo

Posted

There is a recently described neural tumor by Requena, so called Epithelial sheath neuroma, but I don’t see any epithelial component here. Waiting for the answer. 

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Saleem Taibjee

Posted

 

I submitted this recent case because surprisingly I hadn't seen anything quite like it before. I think it best fits with dermal hyperneury.

This was my report, which summarises my thoughts:

"Scale crust with features of lichenification, superficial vascular proliferation with fibrosis. The dermis shows a proliferation of bland nerve bundles. Centrally this is more well-defined resembing solitary circumscribed neuroma. However, there are also more diffusely distributed adjacent smaller nerve bundles. Hence, this may represent a reactive neural hyperplasia which has been termed 'dermal hyperneury'. When localised, this may be associated with trauma including chronic scratching and notalgia paraesthetica. When multiple/multifocal, this can sometimes be associated with syndromes including Multiple Endocrine Neoplasia, Cowden syndrome, and Neurofibromatosis type 2."

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