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Building Blocks of Dermatopathology

BAD DermpathPRO Learning Hub: Diagnostic Clues

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Case Number : CT0040 Adam_Bates

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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History of an indurated plaque on the left buttock, age and sex unknown.


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Adam_Bates

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Multiple dermal well formed discreet non-necrotizing epithelioid granulomata with giant cells and rimmed by lymphocytic infiltrate. No vasculitis is seen. Usual DD of cutaneous granulomata for special stains, microbiology, chest X-ray, serum ACE, Ca to exlude infections, sarcoidosis, FB
Also history is imoprtant e.g Crohn's dieaase. (Cutaneous granulomata in crohn's disease my preceed bowel involvment).

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Adam_Bates

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Noncaseating granulomas with lymphocytes in deep dermis and extending into subcutis. Site is suggestive of cutaneous Crohn disease.
 

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Adam_Bates

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Agree, from the clinical point of view will favor foreign body granulomatous reaction (injection ?) or crohn's ..
 

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Adam_Bates

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I would include in the differential diagnosis cutaneous tuberculosis vs Crohn´s vs foreign body granulomatous dermatitis vs sporotrichosis
 

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Adam_Bates

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Tuberculosis verrucosa vs Crohn' s disease vs foreign body granulomas
 

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Adam_Bates

Posted

Chohn's disease vs foreign body granulomatous disease
 

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Adam_Bates

Posted

Granulomatous Immflamation with Giant cell reaction to foreing body.
 

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Adam_Bates

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Thanks for all your comments and DDs. This was a case of tuberculosis.
 

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