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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 1340 - 12 August 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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75 year-old Vietnamese female with left lower leg biopsy.

Case posted by Dr Hafeez Diwan


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I see a lichenified epidermis with some necrotic keratinocytes and fibrinoid change of the papillary dermis, maybe secondary to scratching. I don´t know what this could be specifically.

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Arti Bakshi

Posted

Difficult….. is there deposition of amorphous material in the sub epidermis? may be congo red and CK5/6 to rule out lichen amyloidosis…not typical though!!... any other ideas??

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Dr. Mona Abdel-Halim

Posted

Yes very difficult :-(( I think we have a lichenoid tissue reaction pattern with vacuolar degeneration, squamatized basal cells and focal subepidermal clefting. I think also we have some ? sclerosis in the papillary dermis.. Could it be early (bullous) LSEA?
Amyloidosis crossed my mind but I do not think there is a definite fissured material here.

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