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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 741 - 18 Apr 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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36 years-old HIV positive female, 35 weeks pregnant with urticarial rash on trunk and bilateral upper and lower extremities. Clinical impression: Pruritic urticarial plaques of pregnancy.

Case posted by Dr. Hafeez Diwan.
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Guest Dr Engin Sezer

Guest Dr Engin Sezer

Posted

Urticarial vasculitis

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Guest
Agree urticarial vasculitis

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Guest Bansal_

Guest Bansal_

Posted

Urticarial vasculitis

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Guest Romualdo C. L. Filho

Guest Romualdo C. L. Filho

Posted

Neutrophilic small-vessel vasculitis. I could not see fibrin deposits in the vessel walls. I think they would be expected in a leukocytoclastic vasculitis, including an urticarial vasculitis, with such a large quantity of neutrophils. I favor an infectious vasculitis and would order special stains and cultures.

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Guest Rodrigo Restrepo

Guest Rodrigo Restrepo

Posted

Urticarial vasculitis

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

I agree with urticarial vasculitis. Infiltrate is too sparse and there’s only mild vascular injury.

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Guest Jim Davie MD

Guest Jim Davie MD

Posted

The venule infiltration by numerous neutrophils (and sparse eosinophils) in the superficial dermis is in stark contrast to the surrounding dermis that shows minimal infiltrate. The 1st low-power image has a tightly cuffed perivascular dermatitis (superficial and deep) that seems to spare the thick-walled arterioles, and variably affect the other vessels; there is negligible interstitial infiltrate, negligible edema, and no significant epidermal changes (? early parakeratosis development). I would lean towards the clinical impression of PUPPP.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I think the walls of the blood vessels are infiltrated with neutrophils, some fenestration of he collagen (edema), prefer urticarial vasculitis. In PUPP, lymphocytic vasculitis is present.

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Dr. Hafeez Diwan

Dr. Hafeez Diwan 125

Posted

I called this urticarial vasculitis.

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IgorSC
Leukocytoclastic vasculitis, could be Urticarial vasculitis.

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