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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 1608 - 24 August 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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45 year-old male with itchy rash on head, trunk and extremities for several months. Physical examination revealed confluent erythematous, non-scaly plaques on face and erosions with scale on border on chest, abdomen and back. A few scaly macules were present on the thighs and upper extremities. There were erythematous scaly patches on the scalp. This biopsy is from the right upper arm.

Case Posted by Dr Hafeez Diwan


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Raul Perret

Posted

I think there are some cells with morphological changes suggestive of viral affection. The clinical description is curious, particularly the long duration of the symptoms. Would perform immunos for herpes family of virus. Other differential could be disseminated dermatophytosis. Psoriasis also crossed my mind because I think there is absent granular layer in the second image and there are dilated blood vessels so  it could also be a consideration if the differentials mentioned above are ruled out.

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vincenzo polizzi

Posted

What about Reactive Perforating Collagenosis?

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biswanath behera

Posted

Whether it is a case of Leukemia cutis ??

 

I am not sure but i am seeing some large cells (?blast cell) in Figure 4 and 5.

 

In figure 5 , whether thr is a band cell present??

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Dr. Hafeez Diwan

Posted

Pemphigus foliaceus.  Direct immunofluorescence was positive.  There are dyskeratotic cells, and absent stratum corneum focally, and in the last image I have tried to photograph an eosinophil.

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