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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 793 - 2nd July 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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Case posted by Dr. Mark Hurt.


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Guest Romualdo

Posted

Parakeratotic foci alternating with orthokeratosis in both vertical and horizontal directions. Original cornified layer still preserved. Slight epidermal hyperplasia with thick suprapapillary plates. These findings are those of pityriasis rubra pilaris.

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Guest Dr. Francisco Vílchez

Posted

Nice case. Agree, PRP.

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IgorSC

Posted

Nice case and demonstration. PRP.

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Robledo F. Rocha

Posted

A checkerboard pattern in the stratum corneum with preservation of the stratum granulosum drives me to agree with Romualdo's diagnosis of pityriasis rubra pilaris. I would feel more comfortable if shoulder parakeratosis at the edges of follicular ostia and keratotic follicular plugs were present in the sample.

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Guest Jim Davie MD

Posted

PRP in absence of clinical hx or other images to the contrary. Checkerboard parakeratosis paired with minimal perivascular chronic inflammation, psoriasiform wide rete pegs, and hypergranulosis.

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Mark A. Hurt MD

Posted

Yes, this is pityriasis rubra pilaris. The patient is a 56 year/old black woman with areas of desquamation, erythema, and hyperpigmentation, and sparing. I don't remember how long the condition existed in the patient. The biopsy was taken from the right calf.

I embedded this specimen to make sure I had a good transition zone, which you can see nicely. Oddly enough, there were doubts among the clinicians when I presented this case at a dermatology grand rounds. However, it [u][i]is [/i][/u]PRP. Good for all of you.

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