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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 1305 - 24 June 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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79 year-old female with rash on chest.
Clinical:Rule out dermal hypersensitivity

Case posted by Dr Hafeez Diwan


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Dr. Mona Abdel-Halim

Posted

This is definitely not dermal hypersensitivity reaction. I am thinking of a Leukemic/ precursor cell infiltration of the skin. Will ask for CBC, Blood film and will do extensive IHC. CD3, 20, 43, 99, 68, 56, 117, myeloperoxidase as well as CD 123. Based on morphology, I am favouring lymphoblastic leukemia.

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Guest Romualdo

Posted

Given the clinical hypothesis, I think a lymphomatoid hypersensitivity reaction must be excluded by history and immunohistochemistry.

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Dr. Hafeez Diwan

Posted

This was a really tough case for me. This is cutaneous angioimmunoblastic T-cell lymphoma. It was CD3, CD4 and focally CD30 positive. The patient's lymph nodes were also positive.

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