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 917 - 24th 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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The patient is a 34 year old man with a shave biopsy of a tender nodule, present for two days, taken from the right second digit.


Case posted by Dr. Mark Hurt


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Eman El-Nabarawy

Posted

Viral cytopathic changes affecting the hair follicle, epidermal hyperplasia with elongated rete ridges, dense inflammatory infiltrate..Milker's nodule(mature lesion).

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Guest Tiberiu Tebeica

Posted

This is an acute inflammatory poxvirus infection, probably milker's nodule. Orf is in the differential, but there is a lack of ballooning degeneration usually seen with orf lesions.

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Guest Maria George

Posted

Periniosis, syphilis, lupus, and MF are the differential here.
I wil be interest in more history and deeper cut or resampling.

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Guest Romualdo

Posted

Viral cytopathic changes. Herpes virus infection (herpetic whitlow) and milker's nodule, especially the first, based on the pseudolymphomatous (I hope!) infiltrate and the presence of one keratinocyte with ground glass chromatin better seen in figure 3.

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Guest Juan Carlos Garcés, Ecuador

Posted

Milker's nodule/Orf.
Happy holidays everyone!

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Eman El-Nabarawy

Posted

I also thought of herpetic whitlow but the clinical presentation( nodule) made me favor the Milker's nodule diagnosis.

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Robledo F. Rocha

Posted

Poxvirus infection with beautiful Guarnieri bodies in the follicular epithelium. Case history favors milker’s nodule / orf.

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Mark A. Hurt MD

Posted

Here are two additional images from recuts. Do they change your opinion?

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE917_image%2005.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE917_image%2006.jpg[/img]

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Dr. Mona Abdel-Halim

Posted

MERRY CHRISTMAS every body :-)) wish you all happy holidays :-))

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Mark A. Hurt MD

Posted

My diagnosis was Molluscum Contagiosum Incognito with pseudolymphomatous reaction.

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Mark A. Hurt MD

Posted

Best to everyone for the holidays! -- and thanks for participating!!

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Robledo F. Rocha

Posted

Quoting Rapini: "The very best special stain in dermatopathology is deeper levels sectioned through the block!"
Merry Xmas to all colleagues and to the staff of DermpathPRO.

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