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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 867 - 15th October 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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The patient is a 54 year old woman who has a few papules that are skin colored and depressed in the center on the dorsum of her hands. A shave biopsy is taken from the dorsum of the left hand.

Case posted by Dr. Mark Hurt.


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Sasi Attili

Posted

[color=#003366][font=arial, sans-serif][size=4][b][i]Annular elastolytic giant cell granuloma[/i][/b][/size][/font][/color]

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[b]Actinic granuloma / [b]Annular elastolytic giant cell granuloma.[/b][/b]

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Guest Romualdo

Posted

Granuloma annulare at severely sun damaged skin.

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Dr. Mona Abdel-Halim

Posted

Agree with actinic granuloma/annular elastolytic giant cell granuloma

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Robledo F. Rocha

Posted

Agree with Romualdo. Actinic granuloma and its synonyms merely represent granuloma annulare in sun-damaged skin.

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Guest Jim Davie MD

Posted

Annular elastolytic giant-cell granuloma (actinic granuloma annulare).

Although usually on head/neck, clinical history of multifocal, bilateral involvement of both dorsal hand would be more consistent with diagnosis of AGA, and help exclude a mycobacterial process. Histologically, there is a giant cell component, and distinct absence of mucin or necrobiotic/altered collagen that would suggest a primary granuloma annulare with incidental (bystander) elastolytic component. I would suspect that an elastin stain would show reduced stainable elastin within the central areas.

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Mark A. Hurt MD

Posted

Here are a few more images. Pancytokeratin, Melan-A, CD63, and VVG. Does it change your diagnosis?

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case867_Image%2008.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case867_Image%2009.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case867_Image%2010.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/Case867_Image%2011.jpg[/img]

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