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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 968 - 10th March 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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The patient is a 33 year old man with a biopsy taken from the right side of the scrotum.

Case posted by Dr. Mark Hurt
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Go to records March 2014

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

Lichenoid tissue reaction for DD. Favor PLEVA or drug reaction.

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IgorSC
I´m back. This is a vacuolar and lichenoid dermatitis. The differential diagnosis is broad. There is a lot of melanophages in the dermis, so I believe it could be a fixed drug eruption.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I think it is fixed drug reaction

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

Acute ulcerating process. What about infections e.g. Herpes, syphilis etc. (needs clin-path correlation and perhaps a few levels for viral inclusions). I thought about pigmented bowen's, melanoma, paget's etc. but think the atypia is probably reactive here.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

I liked the suggestion of infection by Dr Carr :-))

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Eman El-Nabarawy

Eman El-Nabarawy 69

Posted

So as Dr. Carr suggested it's syphilis, probably secondary type because of the pattern of staining of the organisms (mainly epidermal) while it is epidermal and perivascular in the primary type.

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

It was the lack of plasma cells that made me put syphilis 2nd but I seem to remember Mark mentioning it previously so I wanted to consider the diagnosis.

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