Female 67 years

Presented with infiltrated lesions on the trunk for 6 months.

The best diagnosis is:

A. Granuloma annulare

B. Necrobiosis lipoidica

C. Interstitial granulomatous dermatitis

D. Necrobiotic xanthogranuloma

E. Scleromyxoedema

Male 81 years

Presented with a nodular lesion present for 2 years plus. Growing rapidly in recent weeks.

The best diagnosis is:

A. Collision tumour (osteosarcoma and basal cell carcinoma)

B. Basal cell carcinoma with osteosarcomatous differentiation (heterologous differentiation)

C. Basal cell carcinoma with metaplastic bone formation

D. Trichoblastoma with metaplastic bone formation

E. Squamous cell carcinoma with metaplastic bone formation

Female 73 years

Presented with a longstanding lesion on the vulva ?differentiated VIN.

The best diagnosis is:

A. Lichen sclerosus

B. Lichen sclerosus with differentiated VIN

C. Lichen sclerosus with verruciform xanthoma

D. Verruciform xanthoma

E. Differentiated VIN

Female 62 years

Presented with a pigmented lesion on the vulva.

The best diagnosis is:

A. Atypical melanocytic hyperplasia

B. Vulval melanosis

C. Melanoma in-situ

D. Pigmented extramammary Paget's disease

E. Junctional melanocytic naevus

Female 66 years

Presented with a purplish-red papule, skin of leg. Status post leukaemia (in distant past - no further information), and multiple basal cell carcinomas. A punch biopsy was performed.

The best diagnosis is:

A. Melanocytic pilomatricoma

B. Spitz naevus

C. Squamomelanocytic tumour

D. Spitzoid melanoma

E. Melanoma with pseudoepitheliomatous hyperplasia

Female 59 years

A punch biopsy was performed on a nodule, skin of back. Inflammatory disorder? Amelanotic melanoma?

The best diagnosis is:

A. Scar tissue

B. Desmoplastic blue naevus

C. Bednar tumour

D. Desmoplastic melanoma

E. Dermatofibrosarcoma protuberans

Male 38 years

Resection, skin nodule, buttock. Haemangioma?

The best diagnosis is:

A. Melanotic ancient schwannoma

B. Cellular blue naevus

C. Malignant blue naevus

D. Myxomelanocytic tumour

E. Malignant peripheral nerve sheath tumour

Female 75 years

Excision, darkly pigmented nodule, plantar skin.

The best diagnosis is:

A. Hypermelanotic cellular blue naevus (Craig tumour)

B. Dermal hypermelanotic melanoma ('animal-type
melanoma'; pigment synthesisising melanoma)

C. Tumoural melanosis

D. Metastatic melanoma

E. Nodular melanoma NOS

Male 66 years

Presented with multiple subcutaneous lesions neck and chest up to 450mm across. Some features of liposarcoma on CT scan but clinically benign. Biopsy from chest wall.

The best diagnosis is:

A. Metastatic liposarcoma

B. Fibrolipoma

C. Spindle cell lipoma

D. Desmoid fibromatosis

E. Atypical lipomatous tumour

Male 11 years

Patient from Asia presented with an odd dermal annular rash with hypopigmentation on trunk, arms and face. ? sarcoidosis, lymphoma, atypical infection, leprosy. Biopsy from trunk.

The best diagnosis is:

A. Sarcoidosis

B. Tuberculoid leprosy

C. Granulomatous reaction to foreign material

D. Lupus vulgaris

E. Mycobacterium chelonae infection

Male 71 years

Rheumatoid arthritis on gold-based medication. Odd infiltrated area around elbow. ?rheumatoid-associated palisaded neutrophilic and granulomatous dermatitis, ?granuloma annulare ?vasculitis ?morphoea.

The best diagnosis is:

A. Palisaded neutrophilic and granulomatous dermatitis

B. Intravascular large B cell lymphoma

C. Intralymphatic histiocytosis

D. Interstitial granuloma annulare

E. interstitial drug reaction to gold

Female 71 years

Presented with a longstanding nodule from shoulder recently enlarging. Clinically sebaceous cyst.

The best diagnosis is:

A. Metastatic breast carcinoma

B. Primary adenoid cystic carcinoma

C. Spiradenocarcinoma and spiradenoma

D. Metastatic squamous cell carcinoma

E. Porocarcinoma

Female 16 years

Presented with two firm nodules right and left anterior chest wall.

The best diagnosis is:

A. Cylindroma

B. Microcystic adnexal carcinoma

C. Secondary breast adenocarcinoma

D. Breast adenocarcinoma

E. Secondary adenoid cystic carcinoma

Female 5 weeks

Presented with 200g weight loss since birth. Diarrhoea+++. Recurrent rash flare today. Discrete tiny red scaly elevated papules on back, groin and axilla.

The best diagnosis is:

A. Eczema

B. Congenital leukaemia

C. Langerhan's cell histiocytosis

D. Incontinentia pigmenti

E. Scabies

Female 35 years

10 weeks pregnant with third pregnancy. Seven day history of joint pain, fatigue, and blisters on elbows and dorsum of hand. Biopsy left elbow.

The best diagnosis is:

A. Linear IgA disease

B. Dermatitis herpetiformis

C. Erythema multiforme

D. Herpes (pemphigoid) gestationis

E. Bullous pemphigoid

Female 63 years

Elliptical excision of subcutaneous nodule right cheek.

The best diagnosis is:

A. Sarcoidosis

B. Mycobacterial infection

C. Granulomatous reaction to Sculptra (poly-L-lactic acid)

D. Granulomatous tattoo reaction

E. Foreign body

Female 84 years

Biopsy skin of right forehead.

The best diagnosis is:

A. Morphoeic basal cell carcinoma

B. Microcystic adnexal carcinoma

C. Micronodular basal cell carcinoma

D. Adenoid cystic carcinoma

E. Trichoepithelioma

Female 83 years

Presented with a nodule on the scalp, slowly enlarging in size.

The best diagnosis is:

A. Primary syringoid eccrine carcinoma of skin

B. Metastatic carcinoma of breast

C. Morphoeic basal cell carcinoma

D. Microcystic adnexal carcinoma

E. Adenoid cystic carcinoma

Female 59 years

Presented with a tumour on the left arm.

The best diagnosis is:

A. Low grade fibromyxoid sarcoma

B. Neurofibroma

C. Dermatofibrosarcoma protruberans

D. Perineurioma

E. Plexiform schwannoma

Male 52 years

Presented with a tumour on the right wrist.

The best diagnosis is:

A. Cellular blue naevus

B. Metastatic melanoma

C. Clear cell sarcoma

D. Giant cell tumour of tendon sheath

E. Metastatic renal cell carcinoma

Male 55 years

Presented with a right parietal scalp lesion described as an ulcerating tumour increasing in size for six weeks ?sebaceous naevus.

The best diagnosis is:

A. Basal cell carcinoma with metaplastic component

B. Basal cell carcinoma with desmoplasia

C. Basal cell carcinoma with coincident squamous carcinoma

D. Carcinosarcoma

E. Carcinoma with divergent differentiation

Female 61 years

Presented with a ?pyogenic granuloma on the right shoulder.

The best diagnosis is:

A. Atypical fibroxanthoma

B. Melanoma with desmoplastic component

C. Melanoma with phenotypic variation

D. Atypical fibroxanthoma and melanoma

E. Superficial pleomorphic sarcoma

Female 32 years

Presented with a changing naevus with a dark central area, skin left lower eyelid.

The best diagnosis is:

A. Melanoma arising in pre-existing intradermal naevus

B. Naevus with dysplasia

C. Blue naevus

D. Deep penetrating naevus

E. Benign melanocytic naevus with an atypical dermal nodule (clonal/combined naevus)

Male 24 years

Presented with a mole on the left cheek.

The best diagnosis is:

A. Predominantly intradermal melanocytic naevus

B. Combined naevus

C. Psuedomelanoma

D. Congenital compound naevus

E. Naevoid melanoma

Female 49 years

Presented with livedo racemosa lower legs for 3 years. Necrotic/vasculitic lesions on ankles for 3 months. Leg/ankle incision biopsy taken.

The best diagnosis is:

A. Polyarteritis nodosa

B. Livedoid vasculopathy & antiphospholipid syndrome

C. Microscopic polyarteritis

D. Churg Strauss syndrome

E. Cholesterol embolism.

Male 81 years

Presented with a twenty year history of chronic dermatitis. Fixed, elevated, slightly atrophic plaques upper arm.

The best diagnosis is:

A. Spongiotic mycosis fungoides

B. Allergic contact dermatitis

C. Fixed drug eruption

D. Pityriasis rosea

E. Pityriasis lichenoides

Male 55 years

Presented with 4 days of tender lesions left elbow, knees, legs and arms. Also iritis, weight loss, headache, synovitis. ? vasculitis ? sarcoidosis.

The best diagnosis is:

A. Granuloma annulare

B. Rheumatoid nodule

C. Rheumatic fever

D. Sweet's syndrome

E. Palisaded neutrophilic and granulomatous dermatitis

Female 57 years

Persistent eczematous eruption with vesicles on extensor surfaces of limbs. ? acute eczema ? drug eruption ? bullous pemphigoid.

The best diagnosis is:

A. Mycosis fungoides

B. Spongiotic drug reaction

C. Pityriasis rosea

D. Contact dermatitis

E. Pityriasis lichenoides.

Male 25 years

Presented with right shoulder lesion. Clinically ? Keloid, hypertrophic scar, fibroma, lichen simplex chronicus.

The best diagnosis is:

A. Hypertrophic scar

B. Fibroma

C. Perineurioma

D. Dermatofibrosarcoma protruberans

E. Dermatomyofibroma

Female 54 years

Presented with a knee nodule. Clinically ?dermatofibroma, keloid, scar, xanthogranuloma.

The best diagnosis is:

A. Inflamed haemangioma

B. Folliculitis

C. Granuloma annulare

D. Dermatofibroma

E. Erythema elevatum diutinum

Female 28 years

Presented with a nodule on the thigh.

The best diagnosis is:

A. Malignant melanoma

B. Aneurysmal fibrous histiocytoma

C. Angiosarcoma

D. Kaposi's sarcoma

E. Dermatofibrosarcoma protruberans

Female 32 years

Presented with a papule on ear, clinically ?haemangioma, lymphoma, pseudolymphoma, Spitz tumour.

The best diagnosis is:

A. Haemangioma

B. Angiolymphoid hyperplasia with eosinophilia

C. Kaposi's sarcoma

D. Fibroma

E. Scar

Male 73 years

Presented with a nodule on the right temple, more than 50mm. Recurrent mass, previous neurofibroma ?lymphoid tissue.

The best diagnosis is:

A. Malignant peripheral nerve sheath tumour

B. Cutaneous follicle centre lymphoma in recurrent
neurofibroma

C. Scar with cutaneous lymphoid hyperplasia

D. Pseudolymphomatous persistent insect bite reaction

E. Angiolymphoid hyperplasia.

Female 60 years

Presented with an odd 20mm erythematous patch surrounded by a collarette of scale on the left palm. Clinically ? porokeratosis, Bowen's, base of blister.

The best diagnosis is:

A. Punctate porokeratosis

B. Punctate palmoplantar keratoderma

C. Palmar pits of Gorlin's syndrome

D. Circumscribed palmar hypokeratosis

E. Epidermal naevus

Female 67 years

Presented with a warty lesion on the upper lip, possibly a viral wart, SCC or sebaceous hyperplasia. Known metastatic malignant melanoma, currently taking vemurafenib.

The best diagnosis is:

A. Keratoacanthoma of the central face

B. Milia with post-surgical pseudoinvasion

C. Well differentiated squamous cell carcinoma

D. Keratoacanthoma-like squamous keratosis secondary to vemurafenib treatment

E. Squamous syringometaplasia

Male 68 years

Presented with a 12mm nodular lesion over the left zygoma ?BCC.

The best diagnosis is:

A. Marginal zone lymphoma, plasmacytic variant

B. Lymphoepithelioma-like carcinoma

C. Castleman's disease

D. Pseudolymphomatous lupus erythematosus with plasmacytoid dendritic cells

E. Blastic plasmacytoid dendritic cell neoplasm

Male 24 years

A 24 year old male with learning difficulties presented with keratotic papules on the seborrhoeic areas and the trunk.

The best diagnosis is:

A. Grover's disease

B. Hailey-Hailey

C. Pemphigus vulgaris

D. Warty dyskeratoma

E. Darier's disease

Female 77 years

Presented with an ulcer on the left lower leg anterolaterally.

The best diagnosis is:

A. Martorell ulcer

B. Stasis dermatitis

C. Acroangiodermatitis

D. Vasculitis

E. Response to exogenous trauma

Female 34 years

Presented with a 5/7 history of erythema to trunk and limbs with blistering and mucosal ulceration.

The best diagnosis is:

A. Staphylococcal scalded skin syndrome

B. Erythema multiforme

C. Toxic epidermal necrolysis

D. Exogenous trauma

E. Epidermolysis bullosa acquisita

Female 61 years

Presented with several indurated nodules on the lower leg. History of Graves' disease. ? pretibial myxoedema, ?panniculitis.

The best diagnosis is:

A. Panniculitis NOS

B. Trauma

C. Injected material

D. Lupus profundus

E. Pancreatic panniculitis