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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 1520 - 21 April 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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47 year-old female with biopsy of single lesion from right instep.

Dr Hafeez Diwan.


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Raul Perret

Posted

I am struggling with this one, the overall histology as well as the clinical history makes me consider acrodermatitis chronica atrophicans in first place (maybe early presentation as atrophy is not present) but of course I would talk with the clinicians first, other thoughts were secondary syphilis (dont think so) and dermatophyte infection (doubt it) but would still perform special stains.

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Dr. Mona Abdel-Halim

Posted

Thought of secondary syphilis but the biopsy is siperficial to assess depth of infiltrate

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Nitin Khirwadkar

Posted

Fungal infection and secondary syphillis come to mind.

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vincenzo polizzi

Posted

Difficult case, with an overall feature consistent with secondary syphilis...but so many epidermal and dermal neutrophils?  

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Arti Bakshi

Posted

Single lesion on instep also odd for syphilis, but can't come up with any other ideas!!

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Dr. Hafeez Diwan

Posted

Secondary syphilis.  The spirochete antibody showed numerous organisms and the RPR is positive as well.  Patient is responding well to antibiotic.

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