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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 2832- 14 May 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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M55. Mole on back. Wife thinks it’s got darker and increased in size. Exclude melanoma


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vincenzo

Posted

Kamino’s bodies. Maturation. Epidermal rete ridge hyperplasia. The mitosis are probably superficial and near the epidermal rete ridge. A challenging case. 

Favor an AST, but I’m not able to rule out nevoid melanoma. 

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Meenakshi Batrani

Posted

Atypical spitzoid. Difficult to say benign or melanoma. 

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Dr. Richard Carr

Posted

Agree not an easy case. We favoured SSMM with some Reed-like features. I thought these were mainly colloid bodies rather than the typical pale pink Kamino bodies. Quite a compact naevoid dermal component with variation in morphology and up to 5 mitoses /mm2. p16 is the IHC and it's a complete null in the lesion is a great concern with the other features mentioned. BRAF IHC can be useful in such cases to exclude Spitz lesion but I was not happy to call this a Spitz tumour.

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msofopoulos

Posted

On 17/05/2021 at 15:31, Dr. Richard Carr said:

BRAF IHC can be useful in such cases to exclude Spitz lesion but I was not happy to call this a Spitz tumour.

Can I ask if PRAME immunostain of some help in such cases?

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Dr. Richard Carr

Posted

It should be helpful yes.

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