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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.
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Case Number : Case 1785 - 31 March - Dr Richard A Carr Posted By: Guest

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Clinical History: Bleeding pigmented lesion in natal cleft.

Case posted by Dr Richard A Carr


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Raul Perret

Posted

I thought of melanoacanthoma in this case

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Raul Perret

Posted (edited)

forgot to ask if the patient is an adultal although I would still think of melanoacanthoma

Edited by Raul Perret

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vincenzo polizzi

Posted

I have another impression, but waiting for newbies/trainees comments first...

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msofopoulos

Posted

I see hyperplasia of  keratinocytes without atypia and abundance of dendritic melanocytes. I think it is a melanoacanthoma, I am just not sure if it occurs in this location often. Am just waiting for Vincenzo's opinion!

Another thing: Will any of you attend melanoma course in Paris next month?

 

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Robledo F. Rocha

Posted

Epidermis shows psoriasiform hyperplasia due to proliferation of dendritic melanocytes interspersed among keratinocytes with pale-staining cytoplasm, except those keratinocytes of the basal layer and the adnexal epithelium. Pigmented clear cell acanthoma is my opinion.

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Dr. Mona Abdel-Halim

Posted

Glad to see that Robledo has posted my exact opinion!!! I also thought of it as a pigmented clear cell acanthoma .. 

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Sasi Attili

Posted

A bit late. I favour  pigmented clear cell acanthoma too...

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vincenzo polizzi

Posted

I was thinking of Pigmented Clear Cell Acanthoma, too. Typical alternating pattern of involved rete pegs and acanthotic uninvolved adnexal epidermis in fig 1. 

Good week to you all!

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Raul Perret

Posted

2 hours ago, msofopoulos said:

I see hyperplasia of  keratinocytes without atypia and abundance of dendritic melanocytes. I think it is a melanoacanthoma, I am just not sure if it occurs in this location often. Am just waiting for Vincenzo's opinion!

Another thing: Will any of you attend melanoma course in Paris next month?

 

I am a bit away from pathology until september due to a master so cannot go to Paris. However I will be attending ISDP meeting in september as we mentioned before It would be nice to meet you and the rest of colleagues

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msofopoulos

Posted

I will be (probably) attending the Glasgow meeting! It would be nice to meet you and the colleagues too!

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Josie Bisi

Posted

Ok, we have a lesson today! I thougth melanoacanthoma, but now... pigment clear cell acanthoma. Congratulation, Robledo.

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Nitin Khirwadkar

Posted

Would go for a pigmented clear cell acanthoma.

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Admin_Dermpath

Posted

7 hours ago, msofopoulos said:

I see hyperplasia of  keratinocytes without atypia and abundance of dendritic melanocytes. I think it is a melanoacanthoma, I am just not sure if it occurs in this location often. Am just waiting for Vincenzo's opinion!

Another thing: Will any of you attend melanoma course in Paris next month?

 

You should get them to get me to record it  :-)

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Dr. Richard Carr

Posted

Thanks, Vincenzo (for delaying but contributing), Robledo et al for correcting my original diagnosis of melanoacanthoma. I just pulled the slides and agree pigmented clear cell acanthoma fits best. There are neutrophils in the epithelium as well, too much to just be explained  by the anatomic location / surface irritation I think. Surprised I did not appreciate this features at the time (photography often makes one scrutinise sections in greater detail than normal).

Well an even better case than I expected! 

Some regard clear cell acanthosis as a reaction pattern that can  be seen in other lesions and conditions with clear cell acanthoma being a recognisably distinct clinicopathological entity.

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