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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 625 - 31 Oct 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 85 years, blue grey pigmentation on face.
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Go to records October 2012

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Iskander H. Chaudhry

Iskander H. Chaudhry 49

Posted

New comments have been posted on [url="https://dermpathpro.com/difficult_opinion_cases_1/_/case-do010-r12?&do=comments#commentsStart"]difficult case DO010[/url], have a look at it and why not give your own opinion!

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Guest Dr Engin Sezer

Guest Dr Engin Sezer

Posted

Drug-induced (i.e. amiodarone) pigmentation. Any history of drug ingestion?

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Guest Rodrigo Restrepo

Guest Rodrigo Restrepo

Posted

Chrysiasis (gold deposition)

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Very lovely demonstration of chrysiasis..

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Guest Dr. Wilber Martínez

Guest Dr. Wilber Martínez

Posted

Chrysiasis

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Sasi Attili

Sasi Attili 85

Posted

I've had to read this up as I have not seen many cases of pigmentation. Can someone tell me, is the PAS stain shown here -ve as it is just showing the pigment? Because if it is +ve, would imply Amiodarone. Can't find a picture of +ve PAS in amiodarone pigmentation. Guess it should show a purple-magenta colour if positive?

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Dr. Phillip McKee

Dr. Phillip McKee 130

Posted

Well done Engin and Sasi. This is an example of amiodarone pigmentation. This was confirmed clinically. It is very difficult to interpret the PAS. The only other case that I have seen was obviously positive. I guess we will have to go along with the clinicopathological correlation.

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Sasi Attili

Sasi Attili 85

Posted

Thanks Dr. McKee. I have to say I did not find it easy to understand the algorithm for evaluating drug induced pigment deposition. [url="https://docs.google.com/open?id=0B47a2MWGC7eIUnQ0Y3RuTWswR2c"]I tried tabulating what has been written in your book and Weedon, but I am sure it can be bettered.[/url] A project for your next edition maybe?

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Hanan Vaknine MD

Hanan Vaknine MD 18

Posted

Thank you Sasi, I find your table very useful

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