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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 1083 - 18th August Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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The patient is an 83-year-old white man with a shave biopsy of a lesion on the left forearm.

Case posted by Dr. Mark Hurt


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Mark A. Hurt MD

Posted

Clinical Diagnosis: BCC vs Cutaneous Lymphoid Infiltrate + vs Melanoma, Granuloma Annulare

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?Majocchi's granuloma. Suppurative inflammation. I would ask for PAS, to confirm or exclude fungi, in the first instance.

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Dr. Richard Carr

Posted

Suppurative granuloma with endothrix (fungal spores in a hair shaft). Look forward to Zn, Gram & PAS. Can all this suppurative inflammation be due to a few fungal spores? Could not see obvious hyphae in the images. Need to r/o atypical mycobacterium e.g. [i]M. Marinum[/i] etc.

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Mark A. Hurt MD

Posted

My diagnosis was:

SKIN, LEFT FOREARM , SHAVE BIOPSY :
-- MAJOCCHI'S GRANULOMA

The last figure contains a hair filament with endo and ectothrix. There are some spores as well, seen on PAS. A few hyphae were identified in the surface cornified layer on PAS. AFB-Kinyoun and Gram were both negative.

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