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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 1280 - 20 May 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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35 year-old female with biopsy of rash on arm.

Case posted by Dr Hafeez Diwan


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Dr. Mona Abdel-Halim

Posted

Irregular psoriasiform hyperplasia with mild spongiosis, focal parakeratosis, extravasated erythrocytes with RBCs in the epidermis (last image). A hint of vcuoar degeeration is also deteced as well as ome plasma cells. I think clinicopathological correlation is important here. I would think first in pityriasis rosea or pityriasiformru reaction.

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Guest Romualdo

Posted

In the first image there is perifollicular (upper left corner) and perieccrine inflammatory infiltrate. If this rash is limited to the arm and clinical findings are supportive I think this could be lichen striatus.

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IgorSC

Posted

Mt first thought was Pityriasis rosea too. Pigmented purpuric dermatosis is another differential diagnosis. Clinical correlacion is important.

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I second pItyriasis rosea, although the site is unexpected.

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Guest Romualdo

Posted

Dr. Hafeez, I would be very grateful if you could answer this question. The rash was limited to the arm or was it disseminated, and the arm was only the site chosen for biopsy? My english is not very good and I understood that it was limited to the arm, so my wrong suggestion of lichen striatus.

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