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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 3071 - 14 April 2022 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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44F Left sole excision. Dark brown macule x 1 year. Irregular border. ?Melanoma ?Dysplastic naevus ?Acral lentiginous naevus


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Mohamed khaled

Posted (edited)

According to the available photos, I am on the side of dysplastic nevus or MANIAC…..benign nevus.

I am affraid of something tricky in this case !!!!

thanks

Edited by Mohamed khaled

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Chirag Desai

Posted

dysplastic compound nevus on volar skin, possibility of MIS cannot be ruled out. 

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The only worrisome feature is pagetoid scatter at the edge of lesion. otherwise I favor a benign diagnosis. Can always supplement with some stains - p16, PRAME etc.

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Agree with MANIAC. Acrosyringeal regions spared, overall in stratum corneum. 

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Saleem Taibjee

Posted

Hi. Yes, I favoured benign acral naevus. The lesion is small and well-demarcated, and the upward spread is allowable for this anatomical site. I'm not sure it is quite dramatic enough for MANIAC (melanocytic acral naevus with intraepidermal ascent of cells), but that's a moot point anyway.

BW, Saleem

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