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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 578 - 27 Aug 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 67 years with blisters on the trunk.
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Go to records August 2012

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Guest Dr. Francisco Vílchez

Guest Dr. Francisco Vílchez

Posted

Suprabasal clefting. No eosinophils. Pemphigus vs. Grover´s.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

[b]Focal Suprabasal clefting, no esinophils, pathologically favors Grover's. Still on clinical basis, pemphigus is favored. [/b]

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Sasi Attili

Sasi Attili 85

Posted

Looks like Grover's. But the clinical history of blisters is unusual for Grover's. Need DIF studies to differentiate from pemphigus therefore.

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Guest MarieMD

Guest MarieMD

Posted

focal acantholytic dyskeratosis c/w Grover's dz in this setting.

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Guest Dr Engin Sezer

Guest Dr Engin Sezer

Posted

I feel that small size of the lesion (involvement of just a few rete ridges) may be a clue for pemphigus-like variant of Grover's disease to differentiate from P. vulgaris. I'm curious about the Immuno results though.

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Dr. King-Chung Lee

Dr. King-Chung Lee 4

Posted

In the low power picture, there are zones of pale suggesting spongiosis. I favor Grover's disease. Blisters, though rare, is possible in Grover.

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Guest Susan YH Shih

Guest Susan YH Shih

Posted

I see acantholysis with dyskeratosis, although no typical corps ronds or grains found. Besides, focal tombstone appearance is noted. Based on multiple patterns found in a single lesion, I wound say Grover's disease. A DIF is crucial still.

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Iskander H. Chaudhry

Iskander H. Chaudhry 49

Posted

The diagnosis is paraneoplastic pemphigus. All the differentials are acceptable, the final diagnosis was based upon immunofluorescence and correlation with the clinical history.

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