Jump to content
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 1337 - 07 August Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

F60. Rash on vancomycin. c/o Dr Nick Tiffin

Case posted by Dr Richard Carr


  Report Record

User Feedback


Arti Bakshi

Posted

Busy superficial dermis with a perivascular and interstitial infiltrate (includes eosinophils). I think many of the oval/ spindle cells may be mast cells, so would do CD117 stain. Increased basal pigmentation, possible subtle interface change
D/D - urticaria pigmentosa vs drug reaction.

Share this comment


Link to comment
share_externally

I think this is a drug reaction with many histiocytoid mononuclear cells that are in fact immature myeloid cells. A pattern that can be seen in some cases of Histiocytoid Sweet Syndrome.

Share this comment


Link to comment
share_externally

Dr. Mona Abdel-Halim

Posted

I think this is a drug reaction.
The last image is showing large atypical cells, ? Atypical lymphocytes.
Could it be lymphomatoid drug reaction (drug induced pseudolymphoma)
Any CD30?

Share this comment


Link to comment
share_externally

Dr. Richard Carr

Posted

This was a case of DRESS (Drug reaction with eosinophilia and systemic symptoms). You did not appear to appreciate the few necrotic keratinocytes and lymphocyte exocytosis. Given that the cornified layer is normal but there is a plenty going on in both the epidermis and dermis one can predict a very acute rash so DRESS would be a good contender with the combination of interface / lichenoid pattern and eosinophils.

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...