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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 477 Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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Male 75 years, lower legs, itchy well defined nodules with hyperkeratotic surface on an erythematous base.
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  Report Record
Go to records April 2012

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Admin_Dermpath

Admin_Dermpath 1,217

Posted

[b]Richard Carr - Warwick (UK) Wrote:[/b]

The diagnosis is hypertrophic lichen planopilaris. The follicular involvement is a clue to the diagnosis in this case with some squamatisation (loss of the outer basal layer of the follicle) However there should be a fourth image that showed the colloid bodies (perhaps Iskander's team can add this image). Essentially you are looking at nodular prurigo superimposed on the inflammatory dermatosis due the patient constantly rubbing and scratching the lesions. Eosinophils are occastionally seen in lichen planus and lichen planus can be drug induced.

[size=2]Submitted on 08/04/2012 10:59[/size]
[b]Izzat Abdul-kadir - ST2 - York Hospital (UK) Wrote:[/b]

I think the changes are excoriation-induced (compact orthokeratosis, irregular acanthosis and vertical collagen); however, I don't think the hyperplasia is pseudoepitheliomatus enough to call it PN. I can't see basal vacuolation or keratinocytic death, & (I think) I can see eosinophils, so I'm against LP.

[size=2]Submitted on 07/04/2012 20:59[/size]
[b]Graham Reilly - PEH (Guernsey) Wrote:[/b]

Prurigo Nodularis

[size=2]Submitted on 07/04/2012 12:02[/size]
[b]Marcela Saeb Lima - INCMNSZ (mexico City) Wrote:[/b]

hypertrophic lichen planus

[size=2]Submitted on 07/04/2012 02:59[/size]
[b]Marwa Fawzy - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:[/b]

Prurigo nodularis

[size=2]Submitted on 06/04/2012 20:16[/size]
[b]Sasi Attili - (United Kingdom) Wrote:[/b]

Prurigo nodularis

[size=2]Submitted on 06/04/2012 19:40[/size]
[b]Francisco Vílchez Márquez - Department of Dermatology. Clinical Universitary Hospital Virgen de la Victoria. (Málaga, Spain.) Wrote:[/b]

Pickers nodule (prurigo nodularis)

[size=2]Submitted on 06/04/2012 17:02[/size]
[b]Mona Abdel Halim - () Wrote:[/b]

Prurigo nodularis

[size=2]Submitted on 06/04/2012 16:52[/size]
[b]Yüksel Okumuş - Bursa State Hospital (Turkey) Wrote:[/b]

Prurigo nodularis

[size=2]Submitted on 06/04/2012 16:34[/size]

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