Jump to content
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 807 - 22nd July Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

24 years-old white man who has an itchy lesion from the right forearm.

Case posted by Dr Mark Hurt.


  Report Record

User Feedback


Guest Romualdo

Posted

Agree, dermatitis herpetiformis

Share this comment


Link to comment
share_externally

Guest Maria George

Posted

Agree with Dr Engin and Dr Romualdo.
Because Dr Mark like acronyms and mnemonics , I am mentioning this;
PLAID
(for conditions withsubepidermal split, andneutrophils stuffed in dermal papillae)
P
emphigoid (bullous)
L
upus (bullous SLE)
A
cquista (Epidermolysis Bullosa Acquista)
I
gA, linear
D
ermatitis herpetiformis

Share this comment


Link to comment
share_externally

Guest Maria George

Posted

Agree with Dr Engin and Dr Romualdo.
Because Dr Mark like acronyms and mnemonics , I am mentioning this;
PLAID
(for conditions withsubepidermal split, andneutrophils stuffed in dermal papillae)
P
emphigoid (bullous)
L
upus (bullous SLE)
A
cquista (Epidermolysis Bullosa Acquista)
I
gA, linear
D
ermatitis herpetiformis

Share this comment


Link to comment
share_externally

Guest Rodrigo Restrepo

Posted

Dermatitis herpetiformis

Share this comment


Link to comment
share_externally

Robledo F. Rocha

Posted

[font="Palatino Linotype, serif"][size="4"]Edematous papillary dermis, infiltrate of neutrophils and nuclear dust at the tip of a dermal papilla that displays a draft of a subepidermal cleft.[/size][/font]
[font="Palatino Linotype, serif"][size="4"]On microscopic examination alone it is not possible to distinguish unequivocally between early dermatitis herpetiformis and early linear IgA dermatosis, but after a case history of lesions on an extremity of a young adult I'll favor the former hypothesis.[/size][/font]
[font="Palatino Linotype, serif"][size="4"]Another differential diagnosis is bullous lupus erythematosus, but no increased mucin can be found in the reticular dermis.[/size][/font]

Share this comment


Link to comment
share_externally

Guest Jim Davie MD

Posted

Agree with Maria's differential, favor DH.
Superficial and deep perivascular lymphocytic dermatitis with neutrophils and lesser numbers of eosinophils. Some leukocytoclastic debris without vasculitis. Diffuse papillary dermal edema. Neutrophils, mild spongiosis in a psoriasiform epidermis. No adnexal involvement, no evidence of bug bite or tinea in the epidermis.

Share this comment


Link to comment
share_externally

Mark A. Hurt MD

Posted

I will post another image at noon central time.

Share this comment


Link to comment
share_externally

Mark A. Hurt MD

Posted

Here is the Direct IF. Final diagnosis at 14:00 central time. Are there any other comments?

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE807_Image%206.jpg[/img]

Share this comment


Link to comment
share_externally

Guest Jim Davie MD

Posted

[color=#000000][font=verdana, arial, Helvetica, sans-serif][size=3]Dermatitis herpetiformis pattern (assuming other Ig results are negative):[/size][/font][/color]
[color=#000000][font=verdana, arial, Helvetica, sans-serif][size=3]Granular IgA deposits at the junction, concentrated in the dermal papillae.[/size][/font][/color]

Share this comment


Link to comment
share_externally

Robledo F. Rocha

Posted

Granular deposits of IgA in the dermal papillae at direct immunofluorescence are characteristic of dermatitis herpetiformis.

Share this comment


Link to comment
share_externally

Dr. Mona Abdel-Halim

Posted

Lovely, agree with DH

Share this comment


Link to comment
share_externally

Mark A. Hurt MD

Posted

[font=arial,helvetica,sans-serif]Clinically, the differential diagnosis included eczema vs dermatitis [color=#1C2837][size=4]herpetiformis[/size][/color].[/font]

[font=arial, helvetica, sans-serif]My diagnosis was dermatitis herpetiformis.[/font]

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...