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BAD DermpathPRO Learning Hub: Diagnostic Clues

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Case Number : CT0015 Admin_Dermpath

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Male 70 years, juicy nodules on back.


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Admin_Dermpath

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Francisco Vílchez-Márquez - Eosinophilic spongiosis: insect bite

Yüksel Okumuş - Insect/arthropod bite reaction. Look for scabies.

Engin Sezer - Eosinophilic spongiosis with a wedge-like dermal infiltration suggestive of a hypersensitivity reaction to insect bite.

Hazem Hamed - Eosinophilic spongiosis, acanthosis and dermal perivascular and periappendageal infiltrate of lymphocytes, plasma cells and eosinophils. No grenz zone is seen. Flame figures are not present. There is no evidence of vasculitis. There are no features to suggest leukemia. Given the clinical appearance of nodules my first differential is Arthropod bite reaction. I think Wells disease is unlikely (epidermal involvement). Is drug reaction a possibility?

I. Abdul-kadir (ST2 histopath) - ?Insect bites.

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