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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 804 - 17th 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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66 years-old female with “blisters.” This biopsy is from the right breast.

Case posted by Dr. Hafeez Diwan


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Guest Dr. Francisco Vílchez

Posted

Pemphigus vulgaris.

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Sasi Attili

Posted

[quote name='I. Abdul-kadir' timestamp='1374053370']
Pemphigus vulgaris.
[/quote]
Agree

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Robledo F. Rocha

Posted

Pemphigus vulgaris, typically presenting as an acantholytic suprabasilar blistering dermatitis.

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Guest Jim Davie MD

Posted

Pemphigus vulgaris.
Histology appears as expected: Suprabasal bullous clefting, with single layer of basal keratinocytes showing nice 'tombstoning' (acantholytic separation between basal keratinocytes, giving a curved apical contour), patchy acantholysis in the separated stratum spinosum, and dermal papillary pseudovillous architecture. Rare eosinophil exocytosis (top right photo). The dermis shows a mixed inflammatory infiltrate, with lymphocytic perivascular dermatitis with edema, rare eosinophils and rare neutrophils.
(There is subtle postinflammatory pigment in the dermis, but no interface component, no dyskeratosis that would suggest a paraneoplastic pemphigus).

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Dr. Hafeez Diwan

Posted

Pemphigus vulgaris. Immunofluorescence showed the typical intercellular pattern for IgG and C3.

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Guest Rodrigo Restrepo

Posted

Too late, but I gree, pemphigus vulgaris.

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