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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 789 - 26th June Posted By: Guest

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12 years-old boy with meatal stenosis and plaque on penis.

Case posted by Dr. Hafeez Diwan.


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Guest Maria george

Posted

Balanitis xerotica obliterans (LS of male gentalia).Bot things in the differentials are plasma cell balanitis, amyloid, connective tissue nevi ,...etc

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nick turnbull

Posted

Lichen sclerosus

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Guest Romualdo

Posted

Lichen sclerosus

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Dr. Mona Abdel-Halim

Posted

Lichen sclerosus

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Dr. Mona Abdel-Halim

Posted

Lichen sclerosus

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Guest Dr. Francisco Vílchez

Posted

Nice lichen sclerosus (BXO)

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Robledo F. Rocha

Posted

There are typical features of lichen sclerosus affecting epidermis and upper dermis, but sclerosis extends down into the deep reticular dermis accompanied by lymphoplasmacytic infiltrate in band-like pattern surprisingly oriented on vertical arrangement.
I think these findings suggest lichen sclerosus / morphea overlap.

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I agree with lichen sclerosus / morphea overlap. The infiltrate and the type of sclerosis extends beyond I would expect for a typical Lichen sclerosus, but the clinical aspect is typical of a Lichen sclerosus.

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Robledo F. Rocha

Posted

There is controversy concerning the relationship of lichen sclerosus to morphea. While some believe both represent a disease continuum, others advocate that these are unrelated entities. I lean in the former direction because both undoubtedly share clinical and histopathologic characteristics, and a [url="http://archderm.jamanetwork.com/article.aspx?articleid=1105208"]recent paper[/url] consistently demonstrates high frequency of genital lichen sclerosus in patients with previously diagnosed morphea.
I wish I could know the panel's opinion about this contentious subject.

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Dr. Richard Carr

Posted

I have never seen morphoea on the foreskin / penis (we get a lot of BXO) or vulva (ditto). We occasionally see superficial morphoea with histological features indistinguishable from LS superficially and so that I can't tell the difference. Most morphoea does not have that though and plasma cells are usually a clue to morphoea and not a feature in LS/BXO. There seems to be something but I don't really know if I have a strong view about the relationship between the two conditions.

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Guest Jim Davie MD

Posted

Agree: Lichen sclerosus (balanitis xerotica obliterans, on penis). Clinical presentation of meatal stenosis and plaque are consistent with the diagnosis.

Glassy solid fibrosis of superficial reticular/papillary dermis, subtle basal vacuolar change, and lymphoplasmacytic inflammatory infiltrate (which tends to get "pushed down" by the glassy fibrosis in the upper dermis).

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Dr. Hafeez Diwan

Posted

This is a case of balanitis xerotica obliterans.

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