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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 1108 - 22nd September 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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63 year old woman with lesion from the left elbow.

Case posted by Dr. Mark Hurt


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Guest Tiberiu Tebeica

Posted

If this were a single lesion, I would call it psoriasiform keratosis. PAS to exclude fungus.

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Robledo F. Rocha

Posted

My first choice is verrucous psoriasis, unless fungi were found or lesion is a well-circunscribed solitary one (psoriasiform keratosis).

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Dr. Richard Carr

Posted

Psoriasis most likley. Agree rather verruciform.

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Dr. Mona Abdel-Halim

Posted

My thought if single: psoriasiform keratosis, if part of a rash or eruption rather than a single lesion, then will consider it verrucous psoriasis.
http://www.ncbi.nlm.nih.gov/pubmed/15900122

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Mark A. Hurt MD

Posted

Well done, everyone; I struggled with this. I considered verruciform xanthoma (but no excess histiocytes in the suprapapillary plate regions with CD68, and the cornification pattern for VX was not right), fungus (pas negative), 2ndary syphillis (neg for treponema), psoriasiform keratosis (clinical history supported more lesions). Thus, my diagnosis was psoriasis (which was in the clinical differential diagnosis).

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