Male 69 years

Extensive desquamation and superficial blistering, redness across face chest back, no mucosal disease. PMH psoriasis.

Which self antigen is classically targeted in this condition:
A) Desmoglein 1
B) Desmoglein 3
C) Desmoglein 1 and 3
D) Desmocollin 1

Male 81 years

Superficial cutaneous lump left upper arm.

Of the following, what is the most likely primary site giving rise to this lesion?
A) Cutaneous
B) Renal parenchyma
C) Sacrum
D) Lung

Female 76 years

Non-scaly erythematous rash over abdomen, torso, limbs.

What molecular test may the oncologists request on this sample to guide adjuvant treatment?
A) POLE
B) HRD (including BRCA1/2)
C) BRAF
D) Mismatch repair IHC

Male 68 years

New subcutaneous nodule, potential CAR-T trial patient.

What translocation is likely to be present in this neoplasm?
A) IgH::BCL2
B) IgH::BCL6
C) PML::RARA
D) IgH::CCND1

Male 86 years

Slow growing fibrous nodules intertragal notch and retroauricular area? Diagnosis uncertain.

A) Fibroepithelial polyp
B) Haemangioma
C) Rhinophymatous rosacea
D) Chondroid syringoma

Female 42 years

Longstanding alcoholic liver disease. 3-4 wks history of necrotic rapidly progressing ulceration lower abdomen. No preceding trauma or anticoagulation. Recently started furosemide and spironolactone.

A) Pyoderma gangrenosum
B) Angiosarcoma
C) Calciphylaxis
D) Microvenular haemangioma

Male 64 years

Longstanding featureless plaque perianal skin with low grade inflammation? Seborrhoeic keratosis.

A) Verruca vulgaris
B) Porokeratosis
C) Inflammatory linear verrucous epidermal naevus (ILVEN)
D) Verrucous psoriasis

Male 88 years

Long standing irritated lesion back. ? Inflamed cyst? SCC.

A) Epidermoid cyst with focal sebaceous differentiation
B) Sebaceous adenoma
C) Squamous cell carcinoma arising from an epidermoid cyst
D) Proliferative epidermoid cyst

Male 48 years

Axillary lesion? pyogenic granuloma? Cyst.

What is the most likely differential diagnosis?
A) Metastatic apocrine breast carcinoma
B) Primary cutaneous apocrine carcinoma
C) Others
D) All the above

Male 29 years

Lesion on the back.

What is the most likely diagnosis?
A) Langerhans cell histiocytosis
B) Juvenile xanthogranuloma
C) Erdheim-Chester disease
D) Rosai-Dorfman disease

Male 59 years

Multiple lesions on the trunk.

A) Langerhans cell histiocytosis
B) Urticaria
C) Plasmacytosis
D) Mastocytosis

Female 30 years

Drug user ?vasculitis.

What is the most likely diagnosis?
A) Leukocytoclastic vasculitis
B) Occlusive vasculopathy
C) ANCA-associated vasculitis
D) Others

Female 16 years

Punch biopsy of a plaque on left arm with a clinical query of psoriasis.

A) Psoriasis
B) Elastosis perforans serginosa
C) Kyrle disease
D) Reactive perforating collagenosis

Female 55 years

Lesion from right middle finger, ? sebaceous cyst ? giant cell tumour.

A) Metastatic carcinoma
B) Squamoid eccrine ductal carcinoma
C) Digital papillary adenocarcinoma
D) Apocrine cystadenoma

Female 1 days

Congenital erythroderma with thick adherent feathery scale.


A) Ichthyosis vulgaris
B) Ichthyosis follicularis
C) Conradi-Hunermann-Happle Syndrome
D) Keratosis pilaris

Male 5 years

Polypoid lesion right ear.

A) Melanoma
B) Benign intradermal naevus
C) Spitz naevus
D) Cellular blue naevus

Male 77 years

Acute onset of violaceous nodules on trunk and limbs. Biopsy from shoulder.

What is the most likely diagnosis?
A) Sarcoidosis
B) Lupus
C) Granuloma annulare
D) Mycosis fungoides
E) Sweet's syndrome

Female 58 years

Cyst like lesion right leg.

What is the most likely diagnosis?
A) Adenoid cystic carcinoma
B) Secretory carcinoma
C) Adenoid basal cell carcinoma
D) Cribriform tumour
E) Metastatic cribriform breast carcinoma

Female 58 years

Recurrent melanocytic lesion right forearm.

What is the most likely diagnosis?
A) Spitz melanocytoma
B) Intradermal naevus
C) CRTC1::TRIM11 fused cutaneous tumour
D) Clear cell sarcoma

Female 15 years

Gutatte hypopigmentation on lower limbs.

What is the most likely diagnosis?
A) Guttate morphea
B) Hypopigmented mycosis fungoides
C) Inflammatory vitiligo
D) Pityriasis alba
E) Post inflammatory hypopigmentation

Male 59 years

Lesion on the right lateral chest.

A) Angiosarcoma
B) Plemorphic variant of Kaposi Sarcoma
C) Nodular melanoma
D) Symplastic haemangioma

Female 85 years

Right sided labia majora lesion measuring 40mm, firm, not painful, not vascular, skin above intact.

A) Reactive follicular hyperplasia
B) Chronic lymphocytic leukaemia
C) Follicular lymphoma
D) Marginal zone lymphoma

Female 37 years

Multiple cystic nodules on right buttock ?panniculitis ?reaction to vaccine injection as a child.

A) Dermal lipoma
B) Elastofibroma
C) Connective tissue naevus
D) Pseudolipomatosis cutis

Female 87 years

Previous left forehead excision BCC x2 ?recurrent BCC.

A) Actinic keratosis
B) Squamous cell carcinoma
C) Carcinosarcoma
D) Actinic keratosis and atypical fibroxanthoma

Female 82 years

Excision biopsy melanocytic lesion right upper arm.

A) Superficial spreading malignant melanoma
B) Superficial spreading malignant melanoma with syringotropism
C) Melanoma with micro-satellite
D) Melanoma with LVI

Male 45 years

Punch biopsy right forearm. ? neurofibromatosis.

A) Lepromatous leprosy
B) Sarcoidosis
C) Juvenile Xanthogranuloma
D) Neurofibroma

Female 57 years

Incisional biopsy from a papulo rash with follicular plugging.

A) Lichen planus follicularis tumidus
B) Folliculo-tropic mycosis fungoides
C) Naevus comedonicus
D) Discoid lupus

Male 45 years

Incisional biopsy cheek. Ulcerated rash to both cheeks.

A) Superficial granulomatous pyoderma
B) Granulomatous inflammation
C) Supurative fungal infection
D) Halogenoderma

Female 56 years

Very itchy reticular and hyperpigmented rash under breast and left groin for 6 years . ? lichen planus ? mycosis fungoides. On immunohistochemistry there is a predominant CD8+ T cell infiltrate with loss of CD5 and CD7, and preserved CD2 and CD3. CD30 stains a few cells. T cell clonality was detected on PCR.

The favoured diagnosis is:
A) Lichen planus
B) Lichenoid mycosis fungoides
C) CD8+ Epidermotropic T cell lymphoma
D) Lymphomatoid papulosis

Female 94 years

Widespread rash, papular + haemorrhagic centre. 1 week, ?Vasculitis. On immunohistochemistry the clusters of larger T-cells express CD30 and show some loss of CD7 and are mostly CD4 and CD8 negative. No clone detected and no gene rearrangement. TCR beta polyclonal TCR gamma polyclonal.

The favoured diagnosis is:
A) PLEVA
B) Drug reaction
C) Mycosis fungoides
D) Lymphomatoid papulosis

Male 74 years

Developed maculopapular rash 48 hours ago on upper back. Now on chest starting on face. On immunohistochemistry the infiltrate is entirely T-cells with CD4+ phenotype with strong CD52 and no loss of Pan T cell markers. TCR gammaclonal.

The favoured diagnosis is:
A) Polymorphous light eruption
B) Viral rash
C) T-cell prolymphocytic leukaemia
D) Drug reaction

Male 31 years

Plaques and indurated nodules on legs, arms and one on the left upper eyelid since 2020. There are some follicular papules and pustules. There is some scarring alopecia on the arms over the plaques and nodules. There is a palpable lymph node in left axilla. There is no hepatosplenomegaly. No B symptoms. The skin is itchy particularly at night. On immunohistochemistry there is a T cell infiltrate with the following phenotype - CD2+ CD3+ CD30+/- CD4+ CD5+ CD7+/- CD8- IRF4+/- PD-1+/-, TCR betaclonal TCR gamma suspicious.

The favoured diagnosis is:
A) Intersitial granulomatous dermatitis
B) Granulomatous mycosis fungoides
C) Insect bite reaction
D) Drug reaction

Female 25 years

27 weeks pregnant, 3 weeks history of rash. Pink plaques with scattered pustules upper back and face but started on abdomen (sparing umbilical region), slightly itchy, no mucosal involvement ?neutrophilic dermatosis/Sweet's.

The favoured diagnosis is:
A) Sweet's syndrome
B) Syphilis
C) Polymorphic eruption of pregnancy
D) Pemphigoid gestationis

Male 27 years

AML ?recurrence, previous BMT. ?vascular lesion. Left antecubital fossa.

IHC: SOX-10 and S100 positive (strong and diffuse).

Most likely molecular alteration:
A) FUS::CREB3L2
B) COL1A1::PDGFB
C) EWSR1::FLI1
D) SS18::SSX

Male 55 years

Cyst, right anterior thigh.

The favoured diagnosis is:
A) Intravascular fasciitis
B) Myopericytoma
C) Angioleiomyoma
D) Myofibroma

Female 48 years

Lesion on the left leg.

The favoured diagnosis is:
A) Plexiform neurofibroma
B) Myopericytomatosis, myofibroma-like
C) Plexiform fibrohistiocytic tumour
D) Leiomyomatosis

Female 64 years

Biopsy from a nodule on the right forearm.

A) Subcutaneous panniculitis-like T cell lymphoma
B) γ-δ T-cell lymphoma
C) EBV-positive NK/T-cell lymphoma
D) Lupus panniculitis

Female 69 years

Cyst of the left arm.

A) Glomuvenous malformation (glomangiomyoma)
B) Glomus tumour of uncertain malignant potential
C) Glomus tumour, NOS
D) Malignant glomus tumour

Female 25 years

Lesion on the right upper arm.

A) Ros-1 fused atypical Spitz tumour
B) NTRK-fused atypical Spitz tumour
C) Spitz melanoma
D) Spitz naevus

Male 13 years

Left scalp, patch of hair loss.

A) Discoid lupus erythematosus
B) Late stage folliculitis decalvans
C) Morphea
D) Lichen planopilaris