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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 1191 - 15th January 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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66 Year old female with a mildly itchy rash for sometime. Rash on torso and legs.

Torso clinically eczematous but the legs show erythema and follicular distribution. Biopsy of right lower leg.


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Dr. Mona Abdel-Halim

Posted

Strange case..
Combined spongiotic reaction pattern and sarcoidal granulomatous reaction pattern.
My theory (based on clinical correlation): a granulomatous allergic contact dermatitis.

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Robledo F. Rocha

Posted

I favor disseminate and recurrent infundibulofolliculitis, but I'd add as differential diagnosis an unusual presentation of lichen striatus, granulomatous reaction to foreign material (e.g.: zirconium-content cosmetic), and granulomatous follicular atopic dermatitis.

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?Follicular and granulomatous variants of contact dermatitis.

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Guest Jim Davie MD

Posted

Agree with above differentials.
To add to the differential diagnosis list in this clinical setting (although not my first choice): Folliculotropic CTCL, which may have a perifollicular foreign body type granulomatous reaction, targeted follicular vescicular spongiosis, and attenuated lymphocytic epidermotropism.

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Guest Romualdo

Posted

I think this could be follicular granuloma annulare.

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Dr. Richard Carr

Posted

I guess tuberculid should also be added. Systemic lymphomas may present with cutaneous granulomas too. Other differentials would include Crohn's.

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Iskander H. Chaudhry

Posted

Thank you all for you amazing replies. Final diagnosis was granulomatous drug eruption and the rash cleared with stopping the Statin. Has anyone seen a similar case?

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