Case Number : 86 Posted By: Guest

Iskander Chaudhry - Central Manchester NHS Foundation Trust (Manchester, UK) Wrote:

Thank you for the comments. The diagnosis is Porphria in the setting on PCT in this case. The histology of all types of porphyria are verysimilar. The hylaine material is PAS positive and on DIF positive for IgG. Differentials include pseudoporphyria (Indistinguishable from porphyria cutanea tarda but with normal porphyrin studies), and lipoid proteinosis.

Submitted on 07/10/2010 21:10
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Wayne Grayson - (Johannesburg, South Africa) Wrote:

I favour porphyria. Lipoid proteinosis is another possibility.

Submitted on 07/10/2010 16:39
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Marwa Fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Sorry,i was out of the way,i agree that Lipoid proteinosis & porphyria are suitable diagnoses

Submitted on 07/10/2010 15:42
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Marcela Saeb Lima - Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (Mexico City) Wrote:

Lipoid proteinosis vs porphyria are my diagnoses

Submitted on 07/10/2010 15:33
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Thanks a lot Dr Carr. Your comments is very helpful. As my freind Mona said, lipoid proteinosis is a very important DD.

Submitted on 07/10/2010 15:21
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Thank u very much Dr Carr. It is a pleasure to learn from u.

Submitted on 07/10/2010 15:04
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Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Good morning.. As Mona Said, Lipoid proteinosis is an excellent diagnosis in this case..

Submitted on 07/10/2010 14:53
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Richard Carr - Warwick (UK) Wrote:

Diabetic microangiopathy?

Submitted on 07/10/2010 14:51
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Richard Carr - Warwick (UK) Wrote:

Pseudoporphyria? By the way I left some comments in Case 85 this morning in answer to some of yesterdays questions. Regards to all

Submitted on 07/10/2010 14:43
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Iskander Chaudhry - Central Manchester Trust (Manchester, U.K.) Wrote:

Thank you for the comments. Certainly porphyria is in the differential but what else?

Submitted on 07/10/2010 13:59
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ANDREW DANCKWERTS - WITS UNIVERSITY (JHB, RSA) Wrote:

ERYTHROPOEITIC PORPHYRIA DDx: LICHEN AMYLOIDOSIS

Submitted on 07/10/2010 12:08
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

This picture shows esinophilic haline material deposited within and around the wall of the blood vessels (cuffing) in the upper dermis. There is no extension of the depoition in the surrounding tissue of the dermis. I agree Dr Carlos and Dr Eman that this is porphyria (mostly EPP), but I will also like to say that a very early lsion of lipoid proteinosis will look alike, but with the advancing of the disease, the hyalnization of lipoid proteinosis will extend to involve the whole tissue of the dermis and will cause progressive atrophy of the sweat glands and will be seen progressively increasing around arrector pili muscles and around pilosebaceous follicles.

Submitted on 07/10/2010 07:11
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Porphyria.

Submitted on 07/10/2010 04:11
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Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Good evening... Porphyria.. probably Erythopoietic protoporphyria...Hialyne material surrounding vessels in the papillary dermis..

Submitted on 07/10/2010 00:12
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Marwa Fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Ichthyosis congenita.

Submitted on 06/10/2010 23:55
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