38-year-old male, have fever and elevated transaminases for one month, have multiple tender subcutaneous nodules for 10 days.

36-year-old Chinese femal.

Asymtomatic thickened skin on palms and dosal hands for 2 years. No chemical contact history. Have depression history for several yeas, take 2 antidepressants( no details).  Otherwise well. Negative family history.

Biopsy taken from dorsal knuckle. Picture above show seperated stratum corneum

Left leg biopsy from a 68 year old male.  Sent from a family practice clinic in Riverside, CA.

45 year old female with suspected nevus on her left anterior thigh.

Thrombotic vasculopathy following repair of abdominal aortic aneurysm.

92 year old female with pigmented lesion. The case was submitted for a second opinion consultation.

Key differential diagnosis:

• Borderline melanoctytic tumor
• Atypical Sptiz tumor
• Primary melanoma
• Metastatic melanoma

A 15-year-old girl with congenital perceptive deafness, plantar keratodermia and numerous acneiform, cystic, pus-secreting nodules. A history of recidivant erythematous, gyrate changes (not evaluated by biopsy). This is a 1.5 cm nodule from the forehead with a small central  opening.

Two prior biopsies in the archive - buccal erosions - nonspecific findings, vulvar erythematous papule - acanthotic, psoriasiform epidermis overlying abundant granulation tissue.

A connexin-26 (GJB-2) mutation - F142L type has been confirmed.

52 year old female with several year history of hair loss, posterior scalp. There are 2 patches of alopecia with red inflamed borders and loss of follicles. R/o lupus or other

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23 year old female with hair loss, Rule out discoid lupus, lichen planopilaris, etc.

15-year old girl with 5 year history of purpuric, erythematous to brown macules on lower extremities.

Laboratory findings normal, except elevated IgG and peripheral blood eosinophilia (12%)

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60 year-old woman, recent indolent, unpigmented lesion of the right arm.

• The patient is a 30-year-old female with urticarial plaques.
• Elevated WBC, no comment on differential
• Rule out urticarial vasculitis

23 year-old female with a long-standing (since childhood) history of a slowly enlarging pigmented lesion. 

• 31-year-old female with untreated HIV disease with whole body pruritus, erythroderma for 1 year
• 2 biopsies were done
• R/o CTCL. Seborrheic dermatitis, acquired ichthyosis

• 25-year-old female with a history of malaise, fatigue, arthralgia, and myalgia since January 2009
• Positive ANA
• All CTD serologies have been negative.
• Biopsy interpreted at a dermatopathology lab as LEUKEMIA CUTIS.  Subsequently biopsy was sent for consultation, whereby the consultant agreed with a diagnosis of leukemia cutis.
• The patient was then referred to heme/onc for treatment, at which point the biopsies were reviewed.

• A 43-year-old previously healthy male developed asymptomatic small cutaneous lesions over a 2-year period, initially defined by raised papular lesions, eventuating into depressed white scars. In July of 2009 he developed severe abdominal pain and vomiting. An exploratory laparotomy was performed; a small segment of bowel was removed.

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• 53-year-old female with a history of strokes
• The patient had been on total parenteral nutrition for 2 years.
• Developed a recalcitrant skin rash involving the face, groin and hands for the past several months prior to biopsy.

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• 52-year-old man who rapidly developed extensive cutaneous sclerosis within 2 months of receiving gadolidium
• The patient had multiple biopsies over a 3-year period due to progressive cutaneous disease.
• The most recent biopsy was sent in consultation due to an atypical glandular proliferation concerning for microcystic adnexal carcinoma.  

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• 7-year-old female with a large 10-centimeter plaque in the axilla.
• The plaque showed follicular prominence.
• No specific change.

• A 61-year-old male with an abrupt onset of infiltrative plaques on the trunk.
• A biopsy was performed.