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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 1203 - 02 February 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 56 year old man with shave biopsy of a pigmented patch taken from the upper aspect of the right thigh. Clinical Diagnosis: Rule-out CTCL, poikiloderma.

Case posted by Dr Mark Hurt

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Guest Jim Davie MD


Tinea versicolor (pityriasis versicolor; Malassezia infection). Although the classic 'spaghetti and meatballs' is not prominent, clues I rely upon include: the fungi stain well on plain H&E, have very small spore and hyphae size (down to 2 microns or so), lack the keratinolytic, 'invasive' transverse penetration of keratin layers common in dermatophytes, and do not prompt a significant host inflammatory response.

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Mark A. Hurt MD


Yes, this is a superficial fungal "infection." As Jim points out, it well may be TV. I thought it was interesting to contrast this case with Richard's case from Friday, as both were considered clinically to be MF. Perhaps this case (above) gives ironic meaning to the name mycosis fungoides (which, of course, is a lymphoma and not a fungus).

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