Female 43 years

Multiple lumps fingers of both hands ? vascular ? sarcoidosis.

A) Intravascular lobular capillary haemangioma
B) Spindle cell haemangioma
C) Schwannoma
D) Myopericytoma

Female 66 years

Slowly enlarging lesion right medial cheek

A) Arthropod bite reaction
B) Rosacea
C) Granuloma faciale
D) Angiolymphoid hyperplasia with eosinophilia

Male 70 years

Longstanding slightly depressed "scar-like" lesion left upper back with small cyst like pearly areas ? BCC

A) Sebaceous hyperplasia
B) Atrophic dermatofibroma
C) Multinucleate cell angiohistiocytoma
D) Scar

Male 21 years

Long standing lesion neck, recently itchy ? inflamed naevus.

A) Inflammatory linear verrucous epidermal naevus (ILVEN)
B) Pityriasis rubra pilaris
C) Psoriasis
D) Seborrhoeic dermatitis

Female 30 years

2 year history of red patches on the arms and face.


What is the most likely diagnosis?

A) Granulomatous drug reaction
B) Foreign body reaction
C) Fungal infection
D) Leprosy

Female 72 years

Thickened skin chest wall. History of breast cancer.

What is the most likely diagnosis?

A) Chronic Radiation Dermatitis
B) Radiation induced morphoea
C) Hypertrophic scar
D) Eosinophilic fasciitis

Male 57 years

Lesion on the right thigh.

What is the most likely diagnosis?

A) Langerhans Cell Histiocytosis
B) Spitz naevus
C) Juvenile Xanthogranuloma
D) ALK positive Histiocytosis

Male 65 years

Rash over the last 3 years

Which of the following can be in the deferential diagnosis of this case?

A) Sweet syndrome
B) Leucocytoclastic vasculitis
C) Rheumatoid Neutrophilic Dermatitis
D) Vexas syndrome
E) All of the above

Female 35 years

2 yr history of asymptomatic nodule R forearm. 4mm punch biopsy R forearm.

A skin biopsy reveals granulomatous inflammation and an infective aetiology is suspected. A panel of special stains to investigate further is performed and both Ziehl-Neelsen and Wade-Fite stains are requested.

Identify the correct statement.

A) A Wade-Fite stain is contraindicated due to the risk of carcinogenesis in laboratory personnel.
B) A Ziehl-Neelsen stain can also be used to highlight melanin pigment.
C) A Wade-Fite stain is modified by the omission of alcohol which can remove certain variants of mycobacteria.
D) A Ziehl-Neelsen stain is more useful in identifying Mycobacterium leprae.
E) A Wade-Fite stain is requested to identify fungal organisms.

Female 26 years

Multiple symmetrical pink/yellow papules on face and axilla. 6mm punch biopsy axilla

A 26 year old female presents with multiple papules on the face and in the axilla. The accompanying slide shows the diagnostic histological findings. The pathologist finds this condition can have several acceptable synonyms.

Identify the term below that is not used for this condition.

A) Lupus miliasris disseminates faciei
B) Facial idiopathic granulomas with regressive evolution
C) Acne agminate
D) Acne telangietoides of Kaposi
E) Facial tuberculid reaction

Male 68 years

Thickened plaque L hip. Incisional biopsy.

Patient presents with skin thickening and is seen in the rheumatology clinic. The clinician suspects a diagnosis of limited cutaneous systemic sclerosis.

Identify which of the following is not a key feature of this condition:

A) Raynaud phenomenon
B) Calcinosis
C) Sclerodactyly
D) Lipodystrophy
E) Oesophageal dysmotility

Male 36 years

Presents with widespread fragile blisters with mucosal involvement. A skin biopsy is performed and shows suprabasal acantholysis with intercellular IgG and C3c on in the epidermis on direct immunofluorescence.

Identify the common autoantibody associated with this condition.

A) IgM to desmoglein 3
B) IgG to plectin
C) IgG to desmoglein 3
D) IgM to laminin-5
E) IgG to laminin-5

Male 55 years

Hyperkeratotic hyperpigmented rash on his cheeks. Punch biopsy taken from rash.

A) Post inflammatory hyperpigmentation
B) Ochronosis
C) Tattoo pigment
D) Tumoural melanosis

Male 72 years

Lesion on his left cheek ? BCC

A) Basal cell carcinoma with matrical differentiation
B) Pilomatrixoma
C) Melanocytic matricoma
D) Pilomatrix carcinoma

Female 82 years

Lesion on scalp ? SCC ? BCC

A) Squamous cell carcinoma
B) Malignant proliferating pilar tumour
C) Trichilemmal carcinoma
D) Hidradenocarcinoma

Male 75 years

History of myelodysplastic syndrome and who presented with a 1 year history of weight loss, fatigue and generalised lymphadenopathy of an 8cm brown patch on his right upper chest

A) Leukaemia cutis
B) Cutaneous T cell lymphoma
C) Angiosarcoma
D) Blastic plasmacytoid dendritic cell neoplasm

Male 34 years

Multiple tender nodules on face and body. Managing with pred. Fever also. ?Sweet's ?Sarcoidosis ?lymphoma

A) Atypical mycobacterial infection
B) Erythema nodosum leprosum
C) Fungal infection
D) Sweet's syndrome

Male 54 years

15 year history of nailbed lesion of the right great toe

A) Glomus tumour
B) Atypical/symplastic glomus tumour
C) Atypical glomus tumour with malignant transformation
D) Epithelioid angiosarcoma

Female 84 years

Lesion on scalp. ?irritated seborrheic keratosis, rule out SCC

A) Adenosquamous carcinoma
B) Digital papillary adenocarcinoma
C) Syringocystadenocarcinoma papilliferum and squamous cell carcinoma and seborrheic keratosis
D) Syringocystadenoma papilliferum and squamous cell carcinoma and seborrheic keratosis

Female 52 years

Erythematous macule at the right introitus. ?cause

A) Transitional metaplasia
B) Mucinous metaplasia
C) Zoon's vulvitis
D) Intraepithelial carcinoma

Male 81 years

Scalp lesion. PR and EMA positive. Negative for CD31, CD34, CEA, S100, CD68, Desmin, AE1/3, MNF-116, H- caldesmon, BEREP-4, SOX10 and STAT6.

A) Spindle cell squamous cell carcinoma
B) Perineurioma
C) Cutaneous meningioma
D) Angiosarcoma

Female 81 years

H/O metastatic lung carcinoma. Well demarcated macular rash on trunk and limbs.

What is the likely diagnosis?

A) Lichen planus
B) Lichenoid dermatitis associated with immunotherapy
C) Psoriasis
D) Lupus

Male 39 years

15 year history of hair loss predominantly affect the scalp vertex. On examination, the vertex was diffusely indurated with eroded popular areas, scaling and tufting of hair follicles. Which is incorrect?

A) This is a scarring alopecia
B) Lichenoid inflammation can be seen
C) May be associated with Staph Aureus
D) When pustules are absent, this can clinically resemble pseudopalade of Brocq

Male 28 years

7 year history of lesion on right temple. Started as small coin sized plaque and has progressively grown.

A) Polymorphic light eruption
B) Lymphocytic lymphoma
C) Jessner lymphocytic infiltration of the skin
D) Discoid lupus

Female 77 years

Left breast biopsy. Rapid growth ?pyogenic granuloma. Previous history of breast cancer and radiation.

What is true of this diagnosis?

A) MIR143 and NOTCH1 fusion is commonly described
B) Somatic activating mutation in GNAQ is characteristic
C) MYC amplification is characteristic
D) SERPINE1 and FOSB fusion is described

Male 54 years

Skin punch biopsy, right leg. Metastatic lung cancer, acute purpuric rash with coalescing ulcerated papules and nodules

A) Malignant atrophic papulosis
B) Paraneoplastic vasculitis
C) Disseminated intravascular coagulation
D) Cryoglobulinaemia

Male 58 years

Skin punch biopsy, right hand. Hand nodules, arthritis

A) Cutaneous Rosai-Dorfman disease
B) Indeterminate cell histiocytosis
C) Multicentric reticulohistiocytosis
D) Giant cell tumour of tendon sheath

Male 15 years

Glans penis biopsy, Slowly growing nodule on glans penis

A) Fibromatosis
B) Myointimoma
C) Vascular leiomyoma
D) Myofibroma

Female 9 years

Progressive scaly rash commencing 2 weeks after COVID vaccination.

What is the likely diagnosis?

A) Psoriasis
B) Seborrhoeic dermatitis
C) Psoriasiform adverse reaction to COVID vaccination
D) Pemphigus foliaceous

Male 87 years

Diffuse swelling left side of face including eyelid.

What is the most likely diagnosis?

A) Apocrine carcinoma
B) Primary cutaneous signet ring cell / histiocytoid carcinoma
C) Squamous cell carcinoma
D) Metastatic adenocarcinoma from the GI tract

Female 40 years

Persistent superficial ulcers on both breasts ? pyoderma gangrenosum ? necrobiosis lipoidica

What is the likely diagnosis?

A) Angiosarcoma
B) Diffuse dermal angiomatosis
C) Kaposi sarcoma
D) Pyoderma gangrenosum

Male 25 years

Skin lesion, left upper cheek

What is the likely driving molecular aberration?

A) PTCH1 mutation
B) GRHL fusion
C) CTNNB1 mutation
D) CYLD mutation

Female 30 years

Longstanding pigmented lesion on the left arm with recent change:

A) Melanoma in-situ arising in the background of a naevus
B) Spitz naevus
C) Melanoma
D) Atypical Spitz tumour with MYO5A::NTRK3fusion

Male 75 years

18 months history of erythematous rash

A) Cutaneous T cell lymphoma (transformed mycosis fungoides)
B) Leukaemia cutis
C) Disseminated indeterminate dendritic cell tumour
D) Langerhans cell histiocytosis

Male 11 months

Lesion on the chest since the age of 2 weeks

A) Langerhans' cell histiocytosis
B) Lipid poor xanthogranuloma
C) Mastocytoma
D) Cutaneous T cell lymphoma (primary cutaneous anaplastic large cell lymphoma)

Male 57 years

Lesion on the left lower leg

A) Dermatofibrosarcoma protuberans
B) Haemosiderotic adenodermatofibroma
C) Haemosiderotic fibrolipomatus tumour
D) Phosphaturic mesenchymal tumour