Case Number : Case 26 Posted By: Guest

Phillip McKee - Overseas Consultations (USA) Wrote:

Sorry I am late. The correct answer is patch stage Kaposi's sarcoma. The erythrocytes, hemosiderin deposits along with the plasma cells were the diagnostic clues

Submitted on 15/07/2010 22:13
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Ana Cristina Ruiz - Universidad CES (Medellín Colombia) Wrote:

Perivascular infiltrate with plasma cells and blood vessels with swollen endotehial cells. I think it could be a secondary syphilis.

Submitted on 15/07/2010 17:20
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Rodrigo Restrepo - UPB (Mdlln, Col) Wrote:

Secondary syphilis

Submitted on 15/07/2010 17:04
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Mo - Trainee (India) Wrote:

Hi Doctor Mckee, I hope it is me whose got it right. I would go for kaposi's only because of the haemosidrin which are not seen in the others.

Submitted on 15/07/2010 15:36
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Phillip McKee - Overseas consultation (USA) Wrote:

Wayne (otherwise known as wise owl) speaks words of wisdom!!

Submitted on 15/07/2010 15:34
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Eman El-Nabarawy - Dermatology Department,Faculty of Medicine, Cairo university. (Egypt.) Wrote:

Kaposi's sarcoma.DD inflammatory stage of morphea.

Submitted on 15/07/2010 14:17
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Wayne Grayson - (Johannesburg, South Africa) Wrote:

Another tough case to assess in the absence of clinical data and additional images. In this part of the World, the combination of red cell extravasation, plasma cells and haemosiderin pigment in a skin biopsy very often equates to Kaposi's sarcoma. There is however, a degree of enothelial swelling, and the perivascular arrangement of the plasma cells is rather striking. Consequently, secondary syphilis is a distinct possibility. I look forward to hearing the correct diagnosis!

Submitted on 15/07/2010 14:07
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Phillip McKee - Overseas consultations (USA) Wrote:

Good day to you all. This is a difficult case particularly in the absence of clinical information and not being able to see the whole specimen. One of you is correct but which one?

Submitted on 15/07/2010 14:01
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Miah S - (UK) Wrote:

I wondered about inflammatory phase of morphea as an additional differential

Submitted on 15/07/2010 13:36
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Richard Carr - Warwick (UK) Wrote:

But slightly favour syphilis here (endothelial swelling and the odd histiocyte)

Submitted on 15/07/2010 08:07
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Richard Carr - Warwick (UK) Wrote:

I would add Kaposi's (plasma cells and haemosiderin must alway consider KS)

Submitted on 15/07/2010 07:57
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Marwa M.Fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

secondary syphilis

Submitted on 15/07/2010 07:12
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

I can see perivascular infiltrate made up of lymphocytes, few histiocytes and lots of plasma cells as well as few extravasated RBCs. The infiltrate is forming a tight cuff around the BV. I think this could be: *Borreliosis (erythema chronicum migrans) or(acrodermatitis chronica atrophicans). Examnination of other areas of the biopsy is needed to differentiate. * The possibility of secondary syphilis also can not be excluded from this part.

Submitted on 15/07/2010 06:14
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Juan Carlos Garcés - Hospital Ongológico/Hospital Luis Vernaza (Guayaquil, Ecuador) Wrote:

Very difficult.. perivascular infiltrate composed of lymphocytes and plasma cells,a mitosis,some karyorrhexis and a little mucine. Perhaps Lyme disease or morphea?

Submitted on 15/07/2010 06:00
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