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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 1110 - 24th 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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50 year-old male with vesicular rash. This biopsy is from the right ventral wrist.

Case posted by Dr. Hafeez Diwan.
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Go to records September 2014

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Guest Tiberiu Tebeica

Guest Tiberiu Tebeica

Posted

dermatitis herpetiformis (most likely) vs. linear IgA bullous dermatosis vs. BP (less likely)

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Robledo F. Rocha

Robledo F. Rocha 336

Posted

An edematous papillary dermis showing neutrophilic microabscesses and reticular network of fibrin made me favor dermatitis herpetiformis. Extensor surface of upper limb is a typical site. Linear IgA disease, its look-alike, is less plausible in a man with his fifties.

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Dr. Hafeez Diwan

Dr. Hafeez Diwan 125

Posted

Immunofluorescence showed this was linear IgA disease.

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

As a general point DH is often hard to diagnose as finding an unexcoriated lesion to biopsy is tricky but histologically we rarely see blistering to the extent seen here so the other suggestions of linear IgA, neutrophil-rich BP and EBA would be more likely. In DH the text-book cases typically have papillary dermal microabscesses limited to a very few dermal papillae and it is one of the (relatively few) indications for close step levels though the entire biopsy.

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