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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 801 - 12th 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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2.5 cm red indurated scaly plaque on the scalp -?BCC ?SCC. No other lesions.

Case posted by Dr. Richard Carr, with special thanks to Dr. Arti Bakshi.


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Agree, Granuloma faciale. I read recently an interesting paper correlating Granuloma faciale with IgG4-related disease.

[url="http://www.ncbi.nlm.nih.gov/pubmed/23211291"]http://www.ncbi.nlm.nih.gov/pubmed/23211291[/url]

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Mark A. Hurt MD

Posted

GF makes sense, but I don't think I have ever seen such a florid example. Most cases I have seen are relatively superficial, not involving adipose tissue. In my experience with GF, I have found that the lesions contain considerable numbers of siderophages. Has anyone else looked for that? I'll be curious to learn the final diagnosis.

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Robledo F. Rocha

Posted

[font=Palatino Linotype, serif][size=4][size=4]Scalp is not a typical site for granuloma faciale. Only to run away from general agreement I will suggest epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) reasoned on vessels lined by plump endothelial cells.[/size][/size][/font]

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Guest Graham Reilly

Posted

Granuloma faciale - although there doesn`t seem to be a clear Grenz zone.

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Dr. Richard Carr

Posted

Thanks all. I called this granuloma faciale too but I had not seen such a florid and deep example either. However it has pretty much all the typical features (can't remember if I saw siderophages but agree Perl's can be nice in such cases). Eduardo Calonje's team presented a retrospective review of 34 cases at the BSD/BAD meeting last week in Liverpool (abstract is probably available on line in the BJD, Vol 169; Suppl 1, Jul 2013) with IgG4 and basically there was no evidence for any association.

Regards to all and enjoy your weekends.

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