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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 1354 - 01 September 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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50 year old man with painful erythema and edema involving the hands and feet, elbows, and knees. Recent diagnosis of AML.

Case posted by Dr Uma Sundram


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Dr. Mona Abdel-Halim

Posted

I am thinking based on the clinical picture and the history of AML of erythrodysthesia, a form of chemotherapy induced acral erythema. The microscopic picture shows focal mild vacuolar degeneration, few scattered apoptotic KCs and minimal perivascular infiltrate and minimal extravasated RBCs. I think we have also some epidermal dysmaturation? Erythrodysthesia can also occasionally affects elbows and knees although mainly it affects hands and feet, also called hand-foot syndrome.

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Arti Bakshi

Posted

Agree with Mona's excellent discussion and conclusion!

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Arti Bakshi

Posted

Are there any particular changes in the acrosyringium in the higher power image?

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Dr. Mona Abdel-Halim

Posted

I think Arti that the acrosyringium is showing concentrated apoptotic KCs in its very superficial end..

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Uma Sundram

Posted

Yes, example of chemotherapy induced acral erythema. Excellent Mona!

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