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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 938 - 27th January 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 a 58-year-old white man with a shave biopsy of a non-healing, red, scaly lesion on the mid nasal area.

Case posted by Dr. Mark Hurt


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Eman El-Nabarawy

Posted

Granuloma faciale.
The presence of parakeratosis may raise the possibility of rare presentation of Trichophyton rubrum infection mimicking GF pathologically. The grenz zone favor GF over arthropod bite reaction.

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Mixed dermal inflammatory infiltrate with neutrophilic vasculitis and Grenz zone formation. This kind of lesion on the face must be Granuloma faciale. These findings are similar to EED, but the clinical picture is different.

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Robledo F. Rocha

Posted

Agree with my colleagues. It's g[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]ranuloma faciale.[/size][/font][/color]

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Mark A. Hurt MD

Posted

Yes, this is granuloma faciale. Clinically, the lesion was thought to be an actinic keratosis or a squamous carcinoma. Congrats to everyone. I thought this was a beautiful example, and I am somewhat surprised that it was not in the clinical differential diagnosis.

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