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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 1258 - 20 April 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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The patient is a 75-year-old white man with a punch biopsy taken from the right upper arm for disseminated lesions.

Case posted by Dr Mark Hurt


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Guest Tiberiu Tebeica

Posted

Looks like actinic granuloma, which might be regarded as a variant of GA. I recently had a similarly looking biopsy from an old patient with disseminated lesions on sun exposed areas of the skin. Elastic stain highlighted a high degree of elastolysis / elastophagocytosis.

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Arti Bakshi

Posted

favour Actinic granuloma due to prominent elastophagocytosis, (But of course, actinic granuloma is considered a variant of GA by many)

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Dr. Richard Carr

Posted

History of disseminated lesions and depth would go better for interstitial GA / interstitial granulomatous dermatitis. Consider interstitial granulomatous drug reaction. Elastophagocytosis is pretty much a given with any histiocytic inflammatory infiltrate.

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Mark A. Hurt MD

Posted

Clinically the diagnosis was granuloma annulare, and thus my diagnosis was interstitial granuloma annulare. Obviously, this kind of case requires clinicopathologic correlation to make sense. It looks as though you all nailed it!

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