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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 1087 - 22nd 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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F30. Acute onset of blisters limited to arms and hands (case c/o Dr Niamh Leonard)

Case Posted by Dr Richard Carr


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Arti Bakshi

Posted

Confluent epidermal necrosis. There is some basal vacuolar change at the junction of viable and necrotic epidermis, but cannot see established inteface change in these images. Therefor would consider other differentials in addition to bullous EM, ?viral (need special stains) ?irritant contact dermatitis

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Irritant contact dermatitis is a good suggestion. I confess I didn't think of it, because I have never seen it.

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Robledo F. Rocha

Posted

Non-inflammatory subepidermal blister with epidermal necrosis favoring thermal injury caused by burns or cryotherapy and, less likely due to restriction of the lesions to distal limbs, toxic epidermal necrolysis.

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Dr. Richard Carr

Posted

A clue. Developed after cooking out doors.

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Phototoxic contact dermatitis / phototoxic dermatitis

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Robledo F. Rocha

Posted

Given the clue, I go with acute phytophototoxic dermatitis.

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Dr. Mona Abdel-Halim

Posted

With the clue, I also agree with acute phototoxic dermatitis

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Dr. Richard Carr

Posted

Yes this was a phytophotoxic dermatitis due to cutting limes in direct sunlight. Apologies for delay there was a national holiday in UK and I wanted to leave a little more time on Friday.

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