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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 2999 - 4 January 2022 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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52 year old male with lesion on back.


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sfwenson

Posted

Nevoid melanoma? Fairly bland, but maybe a banal nevus in the background at the edge. This is one I'd get a second opinion on for sure.

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vincenzo

Posted

Morphologically weird maturation in deep dermis and many plasmocytoid cells, unusual in deep component of a nevus. So there is a suspect nevoid melanoma, How about Prame? Prame is positive ( 4/5 ). So I think this is a nevoid (too nevoid) melanoma. 

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Meenakshi Batrani

Posted

Agree with nevoid melanoma. 

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msofopoulos

Posted

It displays  fibrosis and a  somewhat unconventional maturation with plasmacytoid cells (as Vicenzo noted). It is highly suspicious of melanoma. I would like to see p16 and Ki67 to assess better. I cannot rule out a traumatized/recurrent nevus.

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Uma Sundram

Posted

Nevoid melanoma. An example of how prame can be useful in difficult cases. No prior trauma or therapy in this area. Agree that recurrent nevus is part of the ddx, but prame is quite convincing.

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