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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1590 - 29 July 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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M30. Arm biopsy. Blistering rash.

Dr Richard Carr


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Raul Perret

Posted

Lichenoid pattern with subepidermal blister without significant inflammatory cells. Bullous lichen Planus. There is some perivascular and periadnexal lymphocytic infiltrate that I dont know if its frequent to see

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vincenzo polizzi

Posted

No parakeratosis but there are some eosinophils..What about Lichenoid Drug Eruption?

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Nitin Khirwadkar

Posted

Bullous lichen planus. Yes occasional eosinophils, any IMF? To rule out lichen planus pemphigoides.

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Arti Bakshi

Posted

Agree with all of the above excellent differentials.

The presence of prominent pigment incontinence and eosinophils makes me favour a lichenoid drug reaction more.

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Dr. Mona Abdel-Halim

Posted

Bullos LP. Clinical correlation and DIF to verify lichen planus pemphigoides.

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biswanath behera

Posted

Orthohyperkeratosis, hypergrnulosis, foci of eosinophilic spongiosis, lymphocytis exocytosis, sub epidermal cleft, subepidermal lymphocytic infiltrate, pigmentary inncontinenc, mid to moderate perivascular and periadnexal infiltrate

 

Bullous Lichen planus, DIF to rule out Lichen planus pemphigoides

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Dr. Richard Carr

Posted

All agreed. In keeping with bullous lichen planus (pending IMF to r/o lichen planus pemphigoides).  A mild eosinophil infiltrate was noted in the report too.

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Dr. Richard Carr

Posted

Follow-up (8/8/2016): IMF studies were negative.

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