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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 4039 - 14 July 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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79M Excision left cheek SCC vs BCC
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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

Desmoplastic trichilemmona.

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volha

neither of the differentials of scc or bcc. looks more like hair originated tumour, reverse polarity of nuclei, stromal clefts, and also sclerotic areas , looks like ORS differentiation so i would also agree with DT

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Saleem Taibjee

Saleem Taibjee 0

Posted

Yes, well done, this is a recent case of basaloid and desmoplastic trichilemmoma. The immunostains are shown below, BerEP4 (negative) and CD34 (positive).

Basaloid trichilemmoma is a particular pitfall and I suspect not infrequently misdiagnosed as BCC. Immunos can assist. Here is our previous publication: Turnbull et al. CD34 and BerEP4 Are Helpful to Distinguish Basaloid Tricholemmoma From Basal Cell Carcinoma. Am J Dermatopathol 2018;40:561–566)

BW

Saleem

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