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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 1351 - 27 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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64 year-old female with rash. This biopsy is from the chest.

Case posted by Dr Hafeez Diwan


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Dr. Mona Abdel-Halim

Posted

Interface (lichenoid) tissue reaction with vacuolar degeneration, necrotic KCs, thick stratum corneum with focal PK and a patchy band infiltrate with deep extension, too much dermal mucin, thinking LE (systemic or subacute).

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Arti Bakshi

Posted

Agree with Mona.
Lupus is the first thought, particularly with the increased dermal mucin.
The prominent high necrotic keratinocytes are unusual though....a drug reaction would come in the d/d.

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Guest Romualdo

Posted

Agree with lupus erythematosus, maybe drug induced.

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Dr. Hafeez Diwan

Posted

Lupus erythematosus. The clinical differential diagnosis included subacute lupus.

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