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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 904 - 5th December 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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A 46-year-old woman with a two-month history of widespread eruption.

Case posted by Dr. Hafeez Diwan.


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Guest Saleem Taibjee

Posted

Mound-like parakeratosis - I am considering pityriasis rosea foremost. Differential includes PRP and psoriasis.

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Hanan Vaknine MD

Posted

In addition to the above differential (PR, PRP and PSO) one should add the possibilities of parapsoriasis (digitate dermatosis) and chronic spongiotic dermatitis (including seborrheic dermatitis), I personally go with PRP. clinical correlation is essential in this case.

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Sasi Attili

Posted

Agree with all the differentials suggested. I think this is one that needs CPC.

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Also agree with all dif. diagnosis, but the presence of follicular infundibular hiperkeratosis, the shoulder parakeratosis and the "so difficult to see" areas of alternating orthokeratosis and parakeratosis are more suggestive of PRP.

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Dr. Mona Abdel-Halim

Posted

Agree with the differentials, need CPC

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[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]Pityriasis rubra pilaris.[/size][/font][/color]

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Eman El-Nabarawy

Posted

A case of DD (with clues for PRP) for CPC.

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Robledo F. Rocha

Posted

It seems that a recent lesion of pityriasis rubra pilaris was biopsied, despite the case history of two-month eruption. Pictures do not show psoriasiform epidermic hyperplasia nor the checkerboard pattern with alternating orthokeratosis and parakeratosis, since these features take at least 14 days to develop, but foci of parakeratotic mounds can be easily seen. Other microscopic findings supportive of this diagnosis are follicular plugging hyperkeratosis with shoulder parakeratosis and sparse superficial perivascular lymphocytic infiltrate.

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Dr. Hafeez Diwan

Posted

Pityriasis rubra pilaris. The clinical impression was also PRP.

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