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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 991 - 10th April 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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7 year-old female with a left lower leg lesion.

Case posted by Dr. Hafeez Diwan.


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Guest Romualdo

Posted

Palisades of histiocytes around central focus of necrobiosis admixed with some blue mucin and surrounded by a zone showing perivascular lymphocytic infilrates: Deep (subcutaneous) granuloma annulare.
Age and location are also typical.

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I agree with Romualdo. Deep GA. My differential diagnose is Necrobiosis lipoidica, but there are no plasma cells, the necrotic focus is quite small, can´t see fibrosis and the age of the patient is not typical.

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Robledo F. Rocha

Posted

Fat lobules obliterated by histiocytes arranged in palisades around necrobiotic collagen and mucin. Agree with subcutaneous granuloma annulare.

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Guest Jim Davie MD

Posted

Agree with deep granuloma annulare (aka pseudorheumatoid nodule, subcutaneous granuloma annulare, necrotizing granuloma).
Although unlikely in the context of a lower limb lesion in a child, the differential would include rheumatoid nodule, or mycobacterial/atypical mycobacterial infection.

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Dr. Hafeez Diwan

Posted

Deep granuloma annulare.

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