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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 616 - 18 Oct Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Female with pneumonia and widespread erythema and blistering.
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Go to records October 2012

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pekaragi
The presence of leukocytic vasculitis with eosinophils and ischemic epidermal necrosis and so the clinical background are suspicious for Wegener granulomatosis / Churg Strauss syndrome

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Guest Dr Engin Sezer

Guest Dr Engin Sezer

Posted

Septic vasculitis should also be considered in DD of LCV, Additional gram staining and cultures may be helpful.

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Guest
Widespread LCV and epidermal necrosis: would consider septic emboli (bacteria or fungi) vs drug vs Wegener granulomatosis

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Sasi Attili

Sasi Attili 85

Posted

The epidermal necrosis and blistering (suprabasal) with fibrinoid necrosis of vessel walls associated with a few neutrophils (relatively pauci-inflammatory).

I am not seeing any obvious thrombi, but it is highly suspicious of septic emboli.

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Guest Guillermo Solis

Guest Guillermo Solis

Posted

Septic emboli, plus TEN.

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Guest
Bullous leukocytoclastic vasculitis.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Septic vasculitis.

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Guest hala
leukocytoclastic vasculitis

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Guest MarieMD

Guest MarieMD

Posted

bullous LCV: ddx: drug, infectious, immunologic (Wegener's et al.), paraneoplastic

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Dr. Phillip McKee

Dr. Phillip McKee 130

Posted

Interesting range of diagonoses. The patient had toxic epidermal necrolysis. The complete epidermal necrosis and cell free subepidermal blister with appendageal involvement are characteristic features. Acute leukocytoclastic vasculitis is sometimes a feature in this condition, perhaps mostly in those rare examples assoicated with infection although in this patient the condition was drug-related.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

This was my first DDx but I got deviated by the associated vasculitis!!! Haven't seen this association before.. Interesting

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