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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 1015 - 14th May 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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43 year-old HIV positive female with hypopigmented macules and papules on face.

Case posted by Dr. Hafeez Diwan.


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Guest Romualdo

Posted

Epidermodysplasia verruciformis?

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Dr. Mona Abdel-Halim

Posted

Acquired EDV syndrome in HIV infected patient

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Robledo F. Rocha

Posted

[font=arial,helvetica,sans-serif][color=#000000]Large keratinocytes with pale blue-gray cytoplasm and perinuclear halo, mainly located in the topmost layers of the epidermis, are characteristic of epidermodysplasia verruciformis. The late onset of the lesions makes me wonder about an acquired disease due to subjacent immunosuppression, like the one associated to kidney transplantation.[/color][/font]

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Mark A. Hurt MD

Posted

EV acanthoma (it sounds as though it is disseminated, however, presumably because of the HIV status). These lesions can be preconditions for SCC; I've also seen them with syringofibroadenoma-like changes.

1: Rohwedder A, Foong H, Tyring SK, Rady P, Carlson JA. Incidental
epidermodysplasia verruciformis human papillomavirus infection (EV acanthoma):
evidence for 'field cancerization' and a putative cofactor in seborrheic
keratosis. J Cutan Pathol. 2008 Dec;35(12):1151-5. doi:
10.1111/j.1600-0560.2007.00920.x. Epub 2008 May 20. PubMed PMID: 18494819.

2: Ko CJ, Iftner T, Barr RJ, Binder SW. Changes of epidermodysplasia
verruciformis in benign skin lesions: the EV acanthoma. J Cutan Pathol. 2007
Jan;34(1):44-8. PubMed PMID: 17214854.

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Guest Jim Davie MD

Posted

[quote name='Dr. Mona Abdel Halim' timestamp='1400075699']
Acquired EDV syndrome in HIV infected patient

[/quote]
Agree.

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Admin_Dermpath

Posted

Hafeez is not able to post the diagnosis for some reason he wanted us to post for him. The diagnosis is Epidermodysplasia verruciformis.

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Robledo F. Rocha

Posted

[quote name='Robledo F. Rocha' timestamp='1400078226']
[font=arial,helvetica,sans-serif][color=#000000]Large keratinocytes with pale blue-gray cytoplasm and perinuclear halo, mainly located in the topmost layers of the epidermis, are characteristic of epidermodysplasia verruciformis. The late onset of the lesions makes me wonder about an acquired disease due to subjacent immunosuppression, like the one associated to kidney transplantation.[/color][/font]
[/quote]
I made a mistake by not paying due attention to the case history. The immunosupression in this patient is caused by HIV infection, and not related to organ transplantation as I was wondering.

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