Female 65 years

Asymptomatic soft brown plaques and nodules on the left cheek for one year.

The best diagnosis is:

A. Acne rosacea

B. Granuloma faciale

C. Leukocytoclastic vasculitis

D. Angiolymphoid hyperplasia with eosinophilia

E. Facial pyoderma

Female 79 years

Intermittently itchy hyperkeratotic plaque of 15 months duration arising on the natal cleft.

The best diagnosis is:

A. Porokeratosis

B. Psoriasis vulgaris

C. Inflammatory linear verrucous epidermal naevus (ILVEN)

D. Viral wart

E. Lichen simplex chronicus

Female 77 years

High fever and spreading erythematous plaques dorsum of hand and forearm. Under the care of infectious disease at the time of biopsy and not responding to antibiotics.

The best diagnosis is:

A. Erythema nodosum

B. Infectious panniculitis

C. Subcutaneous Sweet syndrome

D. Lupus panniculitis

E. Nodular vasculitis

Male 30 years

Pigmented nodule left shin.

The best diagnosis is:

A. Epithelioid fibrous histiocytoma

B. Atypical smooth muscle tumour

C. Desmoplastic malignant melanoma

D. Dermatofibroma

E. Desmoplastic Spitz naevus

Female 30 years

Raised purple plaques, erythematous, on lateral thighs. Works outdoors.

The best diagnosis is:

A. Drug eruption

B. Jessner's lymphocytic infiltrate

C. Polymorphous light eruption

D. Horse riding perniosis

E. Lyme disease

Male 25 years

Multiple painful nodules lower leg. Has had new lesions since aged 15.

The best diagnosis is:

A. Schwannoma in neurofibromatosis type 1

B. Leiomyoma in hereditary renal cell carcinoma syndrome

C. Cellular blue naevus

D. Familial glomangiomyoma

E. Palisaded encapsulated neuroma

Male 70 years

Polypoidal lesion on face ?duration.

The best diagnosis is:

A. "Benign" granular cell tumour

B. Malignant melanoma

C. Primitive granular cell tumour

D. Atypical fibroxanthoma

E. Rhabdomyosarcoma

Male 14 years

Asymptomatic nodular mass arising from tendon of hand (finger).

The best diagnosis is:

A. Calcifying aponeurotic fibroma

B. Soft tissue chondroma

C. Epithelioid sarcoma

D. Ossifying fibromyxoid tumour

E. Fibromatosis

Female 28 years

Atypical pigmented lesion on the back.

The best diagnosis is:

A. Superficial spreading melanoma with regression

B. Melanoma with an invasive spindle cell component

C. Recurrent naevus

D. Lentiginous compound dysplastic naevus

E. Invasive extramammary Paget's disease

Female 71 years

Tumour on the tip of the nose.

The best diagnosis is:

A. Metastatic melanoma

B. Epithelioid schwannoma

C. Epithelioid malignant peripheral nerve sheath tumour

D. Cutaneous myoepithelioma

E. Merkel cell/primary cutaneous neuroendocrine carcinoma

Female 13 years

Area of lifelong alopecia on the parietal scalp.

The best diagnosis is:

A. Lymphangiomatosis

B. Scarring alopecia, late stage

C. Granulomatous dermatosis

D. Cutaneous meningioma

E. Aplasia cutis congenita

Male 39 years

A 1.5 year history of a cystic lesion posterior scalp.

The best diagnosis is:

A. Malignant blue naevus (blue naevus-like
melanoma)

B. Pigmented epithelioid melanocytoma (pigment synthesizing melanoma)

C. Cellular blue naevus

D. Tumoral melanosis

E. Deep penetrating naevus

Female 43 years

Chicken skin appearance to neck. Family history of similar condition. Biopsy right side of neck.

The best diagnosis is:

A. Normal skin

B. Solar elastosis

C. Pseudoxanthoma elasticum

D. Amyloid

E. Elastosis perforans serpiginosa

Female 41 years

Two year history of rash on right knee. Occurred one month after holiday in scrub in remote Scotland with deer. Annular rash. Biopsy right knee.

The best diagnosis is:

A. Fixed drug eruption

B. Atypical annular erythema

C. Jessner's lymphocytic infiltrate

D. Perniosis

E. Erythema chronicum migrans

Male 19 years

Lesion present for many years above left patella.

The best diagnosis is:

A. Foreign body reaction due to pencil

B. Tattoo

C. Blue naevus

D. Cosmetic Filler

E. Haemosiderin deposition secondary to trauma

Female 84 years

Eczematous change left nipple.

The best diagnosis is:

A. Carcinoma in-situ

B. Eczematous change

C. Melanoma in-situ

D. Mycosis fungoides

E. Viral infection

Female 38 years

Multiple lesions removed in past. Presented recently with nine further tumours on body. Previous biopsies have extensive scarring. Biopsies taken from A=nose (256173), B=cheek (256174).

The best diagnosis is:

A. Multiple squamous cell carcinomas

B. Eruptive keratoacanthomas

C. Ferguson-Smith syndrome

D. Keratoacanthoma-like squamous proliferation secondary to vemurafenib treatment

E. Pseudocarcinomatous hyperplasia in lymphomatoid papulosis

Female 54 years

Diabetic with renal failure on dialysis with tertiary hyperparathyroidism. Very painful necrotic plaques lower legs. Biopsy from lower leg.

The best diagnosis is:

A. Vasculitis

B. Necrotising fasciitis

C. Panniculitis

D. Thrombophlebitis

E. Calciphylaxis

Female 64 years

Previous lung carcinoma treated with surgery. Multiple recurring, non-painful violaceous nodules on face. Biopsy from face.

The best diagnosis is:

A. Rosai-Dorfman disease

B. Eruptive xanthoma

C. Langerhans cell histiocytosis

D. Reticulohistiocytosis

E. Leishmaniasis

Male 50 years

Multiple small pale papules. Family history of same. Biopsy from cheek.

The best diagnosis is:

A. Adenoma sebaceum in tuberous sclerosis

B. Fibrofolliculoma in Birt-Hogg-Dube syndrome

C. Fibrous papule of nose

D. Trichoepithelioma in multiple familial trichoepithelioma

E. Trichilemmoma in Cowden's syndrome

Male 54 years

Acute blistering rash volar aspect of arms and anterior legs.

The best diagnosis is:

A. Linear IgA disease

B. Allergic contact dermatitis

C. Pityriasis lichenoides et varioliformis acuta

D. Insect bite reaction

E. IgA pemphigus

Male 25 years

Crohn's disease for 4 years. Six week history of oral ulceration with cobblestone oral mucosa and confluent pustules on lips, associated with confluent vegetative plaque (mildly exudative) in the groin (bilaterally), mons pubis and perineum. History of eye inflammation.

The best diagnosis is:

A. Eosinophilic folliculitis

B. Drug reaction - DRESS syndrome

C. Pemphigus vegetans

D. Pyostomatitis/dermatitis vegetans

E. Fungal infection

Female 17 years

Lesion with blashkoid distribution, clinically epidermal naevus.

The best diagnosis is:

A. Epidermal naevus

B. Linear epidermolytic epidermal naevus

C. Inflammatory linear verrucous epidermal naevus (ILVEN)

D. Bullous congenital ichthyosiform erythroderma

E. Linear porokeratosis

Female 49 years

Two month history of recurrent blisters dorsal hands.

The best diagnosis is:

A. Epidermolysis bullosa acquisita

B. Bullous lupus erythematosus

C. Bullous amyloidosis

D. Bullous diabeticorum

E. Porphyria cutanea tarda

Male 61 years

Left thumb ?pyogenic granuloma ?SCC ?melanoma.

The best diagnosis is:

A. Neutrophilic dermatosis of the dorsal hands

B. Pyogenic granuloma

C. Lymphomatoid papulosis

D. Herpes

E. Orf

Male 37 years

Right jawline 5mm nodule ?keloid.

The best diagnosis is:

A. Desmoplastic Spitz naevus

B. Atypical Spitz Tumour

C. Spitzoid melanoma

D. Deep penetrating naevus

E. Spitz naevus

Male 42 years

Painless, static, well-circumscribed, subcutaneous nodule right lower leg,?lipoma.

The best diagnosis is:

A. Angiosarcoma

B. Haemangiopericytoma

C. Myopericytoma

D. Myofibroma

E. Angioleiomyoma

Male 35 years

Common variable immunodeficiency. Six month history of slowly growing nodules right arm and left lower leg (biopsied). Ziehl-Neelsen, PAS, Grocott and Gram stains all negative.

The best diagnosis is:

A. Necrobiosis lipoidica

B. Granulomas of immunodeficiency

C. Deep granuloma annulare

D. Atypical mycobacterial infection

E. Necrobiotic xanthogranuloma

Female 29 years

Longstanding brown patch right forehead.

The best diagnosis is:

A. Naevus of Ota

B. Post-inflammatory hyperpigmentation

C. Mastocytosis

D. Blue naevus

E. Macular amyloidosis

Female 76 years

Diabetes and thyroid disease. Multiple crusty nodules on trunk.

The best diagnosis is:

A. Excoriation

B. Spider bite

C. Lymphomatoid papulosis

D. Dermatitis artefacta

E. Reactive perforating collagenosis

Male 30 years

Infiltrated scalp nodules and neck lymphadenopathy for 6 months. Biopsy of skin (A - 257213) and lymph node (B - 257214).

The best diagnosis is:

A. Haemangioma

B. Kimura's disease

C. Kaposi's sarcoma

D. Hodgkin's lymphoma

E. Rosai-Dorfman disease

Male 30 years

Very unwell and presented with dramatic widespread noduloulcerative skin lesions following a business trip to Shanghai.

The best diagnosis is:

A. Sarcoidosis

B. Pityriasis lichenoides acuta

C. Secondary syphilis- lues maligna

D. Lupus vulgaris

E. Mycobacterium marinum infection

Female 37 years

Longstanding history of stage IV small cell B-cell lymphoma which transformed to a lymphoplasmacytoid variant despite chemotherapy. She presented with dramatic oral and conjuctival ulceration and scattered pustules.

The best diagnosis is:

A. Herpes simplex

B. Erythema multiforme

C. Toxic epidermal necrolysis

D. Pemphigus

E. Cicatricial pemphigoid

Female 29 years

Atypical pigmented lesion on the leg 1 year post-partum. Punch biopsy (A - 256189) then excision (B 257217).

The best diagnosis is:

A. Combined naevus

B. Dysplastic compound naevus

C. Invasive melanoma

D. Spitz naevus

E. Spitzoid melanoma

Female 23 years

Ulcerated lesion on left buttock. Developed rapidly over a few days.

The best diagnosis is:

A. Pyoderma gangrenosum

B. Cutaneous vasculitis

C. Intravascular CD30 positive T-cell lymphoma

D. Lymphomatoid papulosis type A

E. Peripheral T cell lymphoma, NOS

Male 80 years

Left lower lip, ulcerated lesion suspicion of BCC . Patient has rheumatoid arthritis, chronic kidney disease, atria fibrillation and an adenocarcinoma of prostate in 2009. Currently on Digoxin and Methotrexate.

The best diagnosis is:

A. Herpetic infection associated with pseudolymphoma

B. Lymphomatoid papulosis type C

C. Methotrexate-Induced Lymphoproliferative Disease

D. EBV positive mucocutaneous ulcer

E. EBV-related diffuse large B-cell lymphoma of the elderly

Male 31 years

Opinion on biopsy from HIV2 positive patient with lesion on left palm.

The best diagnosis is:

A. Squamous cell carcinoma

B. Keratoacanthoma

C. Lymphomatoid papulosis type A and pseudoepitheliomatous hyperplasia

D. Verrucous herpes associated with pseudolymphoma and pseudoepitheliomatous hyperplasia

E. Cutaneous T-cell lymphoma and pseudoepitheliomatous hyperplasia

Female 54 years

Biopsy of a cutaneous nodule on the left thigh which had been present for five years.

The best diagnosis is:

A. Reticulohistiocytoma

B. Epithelioid schwannoma

C. Malignant melanoma

D. Spitz naevus

E. Epithelioid benign fibrous histiocytoma

Female 33 years

Superficial dermal nodule shelled out from right forearm.

The best diagnosis is:

A. Malignant melanoma

B. Cellular neurothekeoma (with atypia)

C. Leiomyosarcoma

D. Malignant granular cell tumour

E. Atypical granular cell tumour

Female 27 years

Four months pregnant, presented with a firm enlarging nodule located over the ankle.

The best diagnosis is:

A. Balloon cell melanoma

B. Metastatic renal cell carcinoma

C. Metastatic adrenocortical carcinoma

D. Distinctive dermal clear cell mesenchymal tumour

E. Cutaneous PEComa