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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 1021 - 22nd May 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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9 year-old female with redness and vesicles on face. This biopsy is from the right cheek.

Case posted by Dr. Hafeez Diwan.


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Wedge-shaped cutaneous necrosis, secondary to either infection, vasculopathy or both. Necrotic follicles make me wonder about herpes folliculitis.

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Dr. Mona Abdel-Halim

Posted

I will add also the possibility of hydroa vacciniforme.

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nick turnbull

Posted

Ulceration overlying wedge shaped inflammation with basophilic necorsis. Possibly at the edge old acantholysis or old vessicle. Marked extravasation of red cells. Is that a slate grey multinulated giant cell? I was thinking viral. Eczema herpaticum?

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Guest Jim Davie MD

Posted

Agree with wedge-shaped, near full-thickness necrosis/vasculitis, with reepithelialization at the edges. Likely viral/herpes. Would add to the differential (given the limited history), purpura fulminans secondary to SJS-related sepsis, or rarely secondary to measles.

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Dr. Hafeez Diwan

Posted

Hydroa vacciniforme. It was negative for herpes.

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