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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 1132 - 24th October 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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F40. 6 years, juicy plaques arms & legs some, psoriasiform, some eczematous, some ?CTCL

Case Posted by Dr Richard Carr


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Dr. Richard Carr

Posted

Just a plea to any of you who keep an eye on the cases but never or rarely comment. Please do try and have a go we all learn from the suggestions/discussion of histological features and the more suggestions and discussion on cases the better the learning. This case will have additional H&E at 4pm today and a few further images at 5pm.

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Dr. Mona Abdel-Halim

Posted

Acute spongiotic tissue reaction. Mostly eczema. ? Adult onset atopic dermatitis.

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Robledo F. Rocha

Posted

Epidermotropic lymphocytes seem to be larger than perivascular ones and spongiosis is disproportionately mild. I go with mycosis fungoides.

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Dr. Richard Carr

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1132_RAC6923x10_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1132_RAC6923x20_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1132_RAC6923x40_4pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1132_RAC6923x5b_4pm.jpg[/img]

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Dr. Mona Abdel-Halim

Posted

Syringolymphoid hyperplasia with epitheliotropism of atypical lymphocytes. Syringotropic MF. I was deceived by the overlying spongiotic pattern.

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Dr. Richard Carr

Posted

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1132_RAC6922_Clin_5pm.jpg[/img]

[img]https://dermpathpro.com/uploads/spot_diagnosis_comment_img/CASE1132_RAC6922_IHC_Montage_5pm.jpg[/img]

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Eman El-Nabarawy

Posted

Wounderful clinical photos(valuable addition). Yes, syringotropic MF..

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Mark A. Hurt MD

Posted

I also agree with syringotropic mycosis fungoides, but I would have never made the diagnosis from the surface changes, I'm afraid. I do remember seeing cases with Dr. Ackerman in 2006; in that session, he showed a number of unusual cases of mycosis fungoides in which there was some degree of spongiosis. Still, it's treacherous to make a diagnosis of MF in the face of spongiosis, as there are many mimics can can lead you into the pit of diagnostic despair!

Thank you, Richard.

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Dr. Richard Carr

Posted

All agreed this is a case of Syringotropic mycosis fungoides with rather remarkable superficial spongiotic pattern. CD4+, loss of CD5

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