Female 24 years

Admitted with infective endocarditis. Developed necrotic ulcer on thighs/ abdomen ?purpura fulminans vs calciphylaxis vs septic emboli.

Specimen: Incisional biopsy lower abdomen.

Macroscopic description:
Received is a skin incisional biopsy +2 additional haemorrhagic fibrous/fatty fragments.

Immunohistochemistry:
Von Kossa provided.

Female 57 years

Excision abdomen, atypical squamoproliferative lesion, ?irritated Seb K, r/o dysplasia.

Specimen: Excision of lesion, abdomen.

Macroscopic description:
An ellipse of skin measuring 24 x 18 x 12 mm with a 10 x 9 mm irregular variegated pale brown/grey plaque.

Immunohistochemistry:
N/A.

Female 26 years

Pigmented lesion excised with 2mm margin fat ?MM.

Specimen: Excision biopsy, fourth web space right foot.

Macroscopic description:
Piece of skin measuring 6x5x3mm. Skin surface bears a well defined , variably pigmented patch measuring 4x3mm. Less than 1mm from the closest peripheral edge.

Immunohistochemistry:
n/a.

Male 23 years

New naevus, atypical, blue veil ?severely dysplastic/melanoma.

Specimen: Skin, left posterior knee, excision biopsy.

Macroscopic description:
Skin ellipse, 12x6x2mm, bearing a 4mm well defined pigmented macule, 1mm to the nearest margin. Inked. Serially sectioned, lesion all embedded in A1.

Macroscopic description:
MIB-1 and SOX-10 done (both provided).

Male 60 years

Extensive blistering skin rash.

Specimen: Skin biopsy right side of neck.

Macroscopic description:
6mm skin punch biopsy with 5mm underlying tissue and separate sample for direct immunofluorescence.

Immunohistochemistry:
Immunoflourescence: Direct IMF studies show granular IgA positivity in dermal papillae.

Male 76 years

?Paget's.

Specimen: Perineal skin.

Macroscopic description:
Skin measuring 80x70x8mm. A warty area 65mm is noted.

Immunohistochemistry:
CK 7 positive, CK8/18 positive. Focal positivity with GCDFP-16. Negative stains: SOX10, S100, Melan A, PSA, CK20, CDX2. P63 appears positive in normal keratinocytes. Mucin is seen within lesional cells.

Female 10 years

Irritated mole on occipital scalp.

Specimen: Shave of skin.

Macroscopic description:
Curetted smooth grey nodule 7 x 5 x 2 mm. Bisected. Cut surface is dark brown.

Immunohistochemistry:
S100 positive (relatively dim), Melan A positive. Beta-catenin negative, BRAFV600E negative.

Male 55 years

?BCC.

Specimen: Skin excision left eyebrow.

Macroscopic description:
Ellipse of skin measuring 14x8x3mm. Surface bears a poorly defined, raised pearly lesion 4x4x1mm, this lies 1mm to the nearest margin.

Immunohistochemistry:
n/a.

Female 53 years

Long standing 30 years mainly forearm and buttocks. Itching, blistering. Patient on high dose of steroids. Bullous pemphigoid lesions ?

Specimen: Skin punch biopsy.

Macroscopic description:
5mm punch biopsy bisected all embedded in /1.

Immunohistochemistry:
None.

Male 79 years

Skin lesion scalp ?AFX ?pleomorphic dermal sarcoma. Biopsy proven. Theraputic excision.

Specimen: Skin excision, scalp.

Macroscopic description:
Ovoid skin 35 x 26 x 5mm, with an ill-defined, tan tumour 22mm. CD10 - strong positive , CD31 negative, S100 negative, SMA focal positivity, Desmin negative, Sox 10-negative, ERG-negative AE1/3 , p63, CK14 and CK5/6 provided.

Male 28 years

Left thigh - PRAME negtive, AGK-BRAF fusion, TERT promoter negative, copy number failed.

Female 63 years

Right posterior thigh - PRAME negative, NGS - Tert promoter variant detected, No evidence of BRAF or NRAS variant, Fusion panel - AKAP9::BRAF fusion was detected SNP Array: GAIN: 7, 15q11.2q25.3, 17q11.2q24.3, 20q12q13.33 LOSS: 1p36.33p11.2, 2p25.3p11.2, 4q33q35.1, 9, 12q24.13q24.33

Female 34 years

Right upper back - PRAME negative - MAD1L1::BRAF fusion was detected, No evidence of BRAF or NRAS or TERT promoter variant.

Male 13 years

Lesion back - PRAME negative , RNA Fusion Panel - failed, NGS BRAF V600 E mutation identified. TERT promoter analysis negative, Methylation Epic Array - segmental amplification 7q.

Female 53 years

Right thigh excision and RUL hilar node core biopsy - ANAPC13::BRAF fusion was detected, NGS - No driver variants have been detected in BRAF, NRAS or KIT. TERT promoter analysis negative.

Male 25 years

Left buttock. PRAME negative, RNA fusion panel - GTF2I::BRAF fusion was detected. No oncogenic variants were detected in BRAF, NRAS or KIT.

Female 63 years

Left posterior lower back. PRAME negative, RNA fusion panel: BRAF::AGK fusion is detected. NGS M7.1 panel: No driver variants detected. Copy number variation summary: AMPLIFICATION: None. GAIN: None. LOSS: 5p, 9p (monoallelic CDKN2A/B).

Male 12 years

Left wrist, Right abdomen, PRAME negative, RNA fusion panel: BRAF::AGK fusion is detected. NGS M119.5 panel: No driver variants detected. No TERT promoter variant. Copy number changes - Segmental 7 q gain.

Female 71 years

Right abdomen. PRAME negative, RNA fusion panel - AKAP9::BRAF fusion was detected. No oncogenic variants were detected in BRAF, NRAS or KIT. Copy number variation summary: AMPLIFICATION: None GAIN: segmental 7p, segmental 7q, segmental 20q LOSS: segmental 7q, 20p, segmental 20q, please note there were several separate regions of copy number gain on 7q and 20q, and part of the 7q gain was close to the threshold used to call as amplification.

Female 31 years

Scalp. PRAME negative, RNA fusion panel - ST13::BRAF fusion was detected. No oncogenic variants were detected in BRAF, NRAS or KIT. Copy number variation summary: AMPLIFICATION: None GAIN: None LOSS: segmental 1p, segmental 2 p segmental 2q, 6q, 9, segmental 11q, 13.