Case Number : Case 144 Posted By: Guest

Phillip H. McKee - Overseas consultations (Arizona, USA) Wrote:

The section shows a flame figure in a person who had an insect bite reaction. As stated by many of you the differential diagnosis is broad encompassing most conditions which have a dense infiltrate of eosinophils. Thank you for your contributions and I look forward to your comments tomorrow.

Submitted on 28/12/2010 22:12
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ANDREW DANCKWERTS - WITS UNIVERSITY, JOHANNESBURG (JOHANNESBURG, RSA) Wrote:

FLAME FIGURE SET IN A BACKGROUND OF LYMPHOCYTES, HISTIOCYTES AND OCCASIONAL EOSINOPHILS. THE DIFFERENTIAL DIAGNOSIS IS BROAD - INSECT BITE, DRUG REACTION. ALSO THOUGHT OF AN INFECTION, SUCH AS FUNGAL WITH ? SPLENDORE-HOEPPLI PHENOMENON(ESPECIALLY SPOROTRICHOSIS). I THINK WELL'S SYNDROME (EOSINOPHILIC CELLULITIS) IS LESS LIKELY, AS THE EOSINOPHILIC INFILTRATE IS NOT DENSE ENOUGH. NICE CASE!

Submitted on 28/12/2010 19:40
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Wayne Grayson - (Johannesburg, South Africa) Wrote:

Flame figure present amid a background infiltrate of lymphocytes, histiocytes and eosinophils. The differential diagnosis is fairly broad, but if I have to give one spot diagnosis, it would be an insect bite.

Submitted on 28/12/2010 16:35
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Naglaa Nabil EL Mongy - Cairo University (Egypt) Wrote:

flame figures with mixed inflammatory infiltrate, some eosinophils.D.D.Well's but other D.D. have to be considered: drug reaction? insect bite?

Submitted on 28/12/2010 16:05
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Rodrigo Restrepo - UPB/CES (Mdlln. Col) Wrote:

Flame figure and mixed inflammatory cell infiltration of lymphocytes, histiocytes and some esinophils. DD Insect bite

Submitted on 28/12/2010 11:14
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Amira Tawdy - Cairo University (Egypt) Wrote:

Suppurative granuloma for D.D

Submitted on 28/12/2010 10:38
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Flame figure, infiltrate made of lymphocytes, histiocytes, lots of esinophils and some plasma cells. Could be part of a fungal infection or a parasitic infestation. I think in Well's syndrome the infiltrate is almost exclusively made of esinophils. Nice image.

Submitted on 28/12/2010 06:32
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Flame figure in an eosinophilic dermatosis for DD: such as Well's syndrome.

Submitted on 28/12/2010 05:07
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Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Good evening.. it looks like a "flame figure" to me, and I see some eosinophils in the infiltrate...

Submitted on 27/12/2010 23:33
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Alison Wiseman - (USA) Wrote:

Splendore-Hoeppli phenomenon I think! Would rule out the infective causes related to it.

Submitted on 27/12/2010 23:18
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