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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 834 - 28th August 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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33-year-old female with rash. Clinical differentials include pityriasis rosea. The biopsy is from the left lower back.

Case posted by Dr. Hafeez Diwan.


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Guest Yüksel OKUMUŞ, MD

Posted

Guttate psoriasis.
DDX.Needs PAS stain for fungal infection (Tinea corporis)

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Guest Giovanni Falconieri

Posted

Agree, dermatophytosis on the top of my differential - I would add GMS to the special stain batch. Polys in epidermis not the best feature for PR.

Looking forward to the masters' opinion and congratulation for this superb web site.

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Hanan Vaknine MD

Posted

In addition to above I would also suggest PLC (based on clinical differential and delicate vacuolar interface change)

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Guest Romualdo

Posted

Agree: guttate psoriasis. PAS/ GMS to exclude fungal infection given the neutrophils.

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Wolter Mooi

Posted

Preferred diagnosis: guttate psoriasis. 'Squirting papilla'; Munro microabscess; (focal) parakeratosis; slight psoriasiform rete ridge elongation; clinical information (impression of pityriasis rosea). I would also do a PAS/GMS stain before reporting the lesion.

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Guttate psoriasis. The clinical impression of Pityriasis rosea is quite common, but the neutrophils at the cornea is a good tip to differentiate between them. It is easy to see spongiosis in these cases.

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Dr. Mona Abdel-Halim

Posted

Agree with the mentioned differentials....

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Robledo F. Rocha

Posted

Like my colleagues, I favor guttate psoriasis, but dermatophytosis must be ruled out.

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Guest Jim Davie MD

Posted

[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]Guttate psoriasis. (Although tinea, irritant dermatitis, and seborrheic dermatitis are in the differential, these would be less likely, if truly a diffuse papular/macular PR-like process clinically).[/size][/font][/color]

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Dr. Hafeez Diwan

Posted

Yes, this is guttate psoriasis. The GMS was negative.

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