Classic Example

Trichofolliculoma

A 52-year-old hispanic female presented with a small dome-shaped nodule with protruding trichoids on the nose.

 

Diagnosis: 
Trichofolliculoma
Comment: 

Histological examination shows a cystically dilated follicle communicating with the epidermis. Numerous secondary follicles are present.

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Bowen’s disease (Squamous cell carcinoma in situ)

A 78-year-old female presented with an erythematous crusted palque-like lesion on the right dorsal foot.

Diagnosis: 
Bowen’s disease (Squamous cell carcinoma in situ)
Comment: 

Histrogical findings : Hyperkeratosis with parakeratosis is overlying the full-thickness dysplastic epidermis with loss of maturation and lack of polarity of cells.  The tumor cells contain marked irregular hyperchromatic nuclei with conspicuous nucleoli and abundant cytoplasm. Individually keratinized cells are also seen.

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Tuberculosis verrucosa cutis

This 61-year- old male patient presented with asymptomatic skin lesion on the middle finger of the left of 10 months duration.

Diagnosis: 
Tuberculosis verrucosa cutis
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Conference: 

Apocrine hidrocystoma

Contributor(s): 
Diagnosis: 
Apocrine hidrocystoma
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Vulvar lichen planus

Contributor(s): 
Diagnosis: 
Vulvar lichen planus
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Gout

Contributor(s): 

54-year-old man.  Helix of left ear.  History of gout.

Diagnosis: 
Gout
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Scleredema

Contributor(s): 
Diagnosis: 
Scleredema
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Clear cell hidradenoma

Contributor(s): 

50-year-old man.  Chest mass.

Diagnosis: 
Clear cell hidradenoma
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Lichen nitidus

Contributor(s): 

9-year-old boy with approximately 100 flesh-colored papules on back.

Diagnosis: 
Lichen nitidus
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Nodular hidradenoma

Contributor(s): 
Diagnosis: 
Nodular hidradenoma
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Nevus with pseudovascular spaces

Contributor(s): 
Diagnosis: 
Nevus with pseudovascular spaces
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Rosai-Dorfman disease

Contributor(s): 
Diagnosis: 
Rosai-Dorfman disease
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Chronic urticaria

Contributor(s): 
Diagnosis: 
Chronic urticaria
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Cryoglobulinemia

Contributor(s): 
Diagnosis: 
Cryoglobulinemia
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Darier’s disease

This 44-year-old male presented with hyperkeratotic papules on the forehead, neck, behind the ear and in the groin area. Small depigmented macules on the trunk and upper limbs were also noted as well as skin colored flat surfaced papules on the dorsa of the hands and feet. Palmoplantar pitting and nail changes were also present.

Diagnosis: 
Darier’s disease
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PLEVA with increased CD30+ cells

Contributor(s): 

68-year-old man with a three-year history of an indolent rash which appears approximately every two months.   PLEVA versus lymphomatoid papulosis.

Diagnosis: 
PLEVA with increased CD30+ cells
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Hidrocystoma

Contributor(s): 
Diagnosis: 
Hidrocystoma
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Spitz tumor (borderline lesion)

Contributor(s): 

57-year-old man; lower back lesion

Diagnosis: 
Spitz tumor (borderline lesion)
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Kaposi sarcoma, nodular stage

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Diagnosis: 
Kaposi sarcoma, nodular stage
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Periurethral cyst

A 40-year-old man presented with a soft cystic nodule lateral to the urethral meatus on the foreskin. 

Diagnosis: 
Periurethral cyst
Comment: 

Histological examination shows the cyst is lined by transitional epithelium.

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