Female 67 years

?granulomatous reaction from insect bite ?SK.

Specimen: Currettage left calf.

Macroscopic description:
Disc of skin 12x10mm.

Immunohistochemistry:
/.

Female 84 years

Painful lesion right antihelix ? CDH ? BCC. Wide local excision.

Specimen: Ear.

Macroscopic description:
A skin ellipse 13 x 10 x 4 mm with a white ulcerated patch 7 mm.

Immunohistochemistry:
Nil.

Female 39 years

20 weeks pregnant, second pregnancy. One week history of intensely itchy polymorphic widespread eruption with intact blisters focused around wrists and hands. ?pemphigus gestationis ?PEP, bullous EM (some lesions targetoid, hx of cold sores).

Specimen: Skin punch biopsy right forearm.

Macroscopic description:
Skin punch biopsy 4mm in diameter and 4mm in depth.

Immunofluorescence:
C3: positive, linear basement membrane.
IgG, IgA, IgM: negative.

Male 65 years

Previous multiple AKs/SCCs. Very darkly pigmented small naevus right posterior lower leg. ? benign blue naevus but of uncertain duration - to exclude malignant melanoma.

Specimen: Skin excision right posterior lower leg.

Macroscopic description:
An ellipse of skin measuring 12 x 7 x up to 4mm. The surface bears a brown macule lesion measuring 3mm. This extends to 3mm of the nearest resection margin and is clear of the ends.

Immunohistochemistry:
None performed.

Male 74 years

?Pilar cyst - patient has history. Overlying skin change. Rule out BCC nodular cystic please.

Specimen: Lesion on scalp.

Macroscopic description:
Specimen comprises ovoid portion of skin measuring 33x30x12mm. Skin surface bears central, well defined and pinky coloured nodule which measures 25x23x10mm.

Immunohistochemistry:
N/A.

Female 53 years

Pink resolving lesion, left medial leg, non-specific dermoscopy changes, ?amelanocytic melanoma ?SK.

Specimen: Excision left medial leg lesion.

Macroscopic description:
Ellipse of skin measuring 26x11x12mm.

Immunohistochemistry:
None.

Female 65 years

Left thigh pigmented nodule.

Specimen: Skin excision, thigh.

Macroscopic description:
Ellipse of skin 23x14x12mm. No pigment seen.

Immunohistochemistry:
Positive for desmin and SMA and weakly for AE1/3. Negative for Melan A, CD31, p63, S100 and Sox10. Ki67 shows approximately 10-15% in cycle.

Male 83 years

BCC scalp - excised with 4mm margins.

Specimen: Skin excision, left frontal scalp.

Macroscopic description:
A disc of skin, measuring 38 x 35mm to a depth of 6mm. Lesion position: Central Lesion definition: Ill defined Lesion characteristics: Slightly raised, nodular, pearly Lesion dimensions: 20 x 20mm Closest peripheral margin: 5mm Deep Margin: Inked red.

Immunohistochemistry:
Melan A negative, SOX10 patchy, S100 positive in spindle cells.

Female 18 years

Vascular looking infiltrate, slowly growing lesion ?Kaposi's sarcoma ?Haemangioma.

Specimen: Incisional biopsy, left lower leg.

Macroscopic description:
9mm piece of tissue.

Further work: Perls strongly positive.
Genotypic analysis: No T cell clonality.

Male 74 years

Known metastatic prostate cancer. 2 x 1 cm erythematous plaque right arm 4-5 weeks.

Specimen: Incisional biopsy right arm.

Macroscopic description:
Ellipse of skin measuring 25 x 15 x 11 mm with a firm raised grey coloured area measuring approximately 15 mm maximum dimension.

Immunohistochemistry:
Strong positive expression of NKX3.1, MNF116, AE1/3 and patchy strong positive expression of PSA and PSAP. No expression of CK7, CK20, CK5/6, Melan-A or SOX-10 is seen.