Bad bad bad becomes worse worse worse: metastatic clear cell renal cell carcinoma with sarcomatoid dedifferentiation

Perfect pigmented porokeratosis

Gold medalist (truly) at the Recanalizing Hemangioma World Championships. Hematoidin division.

World's tiniest (2 mm) verruciform xanthoma -- go figure. It was on the cheek -- go figure. He was 90 -- go figure.

Ouch!

Oscar Levant said there’s a fine line between genius and insanity. There’s also a fine (pink) line between making the dx of CNH and not making the dx of CNH

Fifth Dimension dermpath: Up-up and away in my beautiful balloon — my beautiful ALK-fused pigmented Spitz nevus with ballon cell change, that is…

I didn’t really know it existed and then it just showed up. Plaque type trichilemmoma

Use PAS-D to turn a splinter into a MOMA masterpiece

Wound-Seal: it’s baaaaaack!

Reexcision of melanoma with a pigmented surprise

The mesmerizing labyrinthine wonderfulness of ripple pattern basal cell carcinoma

This BCC is looking forward to the weekend.

Cause and effect in action...

This is a public secret message to ⁦Henry YANG⁩ kikoxp.com/posts/13994

This is more of a question than an answer. Balloon cell change in an SK? Weird stuff. Just to pre-answer a potential loose end, the included SOX10 immunostain confirms that the fluffy stuff is non-melanocytic.

This . . . CK20 . . . immunostaining . . . pattern . . . helped . . . establish . . . the . . . diagnosis . . . of . . . Merkel . . . cell . . . carcinoma . . . status . . . post . . . hepatic . . . transplantation . . . . . . It happens. Not often.

The easy diagnosis is two tree trunks. But is that the only diagnosis?