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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 3012 - 21 January 2022 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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57M , Ear. Changing darkly pigmented lesion on lower helical rim. ?Dysplastic naevus.


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PRAME 2/5..is in keeping with nevus; isn’t it?

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Meenakshi Batrani

Posted

On histopathology I was thinking more of nevus with atypia attributed to special site (ear is considered as special site). But, now with IHC markers not sure of nevus. 

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Dr. Richard Carr

Posted

Difficult but on balance we favoured a dysplastic Spitzoid naevus at a special site location. Watchful waiting would seem a safe option. There was a recent paper on the Dysplastic Clark/Spitz (SPARK) in Am. J. Dermpath and the shared some molecular features, all had MAP2K1 mutation.

https://pubmed.ncbi.nlm.nih.gov/33264134/

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msofopoulos

Posted

Isn't it smaller than 4mm? Shouldn't a dysplastic nevus be more than 4mm or SPARK nevi (since they are of Spitz lineage) are excluded?

Once again great instructive case!

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