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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 1613 - 31 August 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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39 year-old male with right shin lesion, clinically: rule out dermatofibroma.

Case Posted by Dr Hafeez Diwan


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User Feedback


Raul Perret

Posted

My interpretation is that we see intra and extracellular deposits of a golden brown exogenous pigment with a macrophagic reaction and dermal fibrotic scarring. The pigment is positive with Perls prussian blue and the last two images I assume are Masson's Fontana? I thought this is either a reaction to a drug like minocycline/anti-malarial/amiodarone drug pigmentation or a reaction to a tattoo. 

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vincenzo polizzi

Posted

Why not a hemosiderotic Dermatofibroma?

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Nitin Khirwadkar

Posted

I would go with Raul's suggestion. Great site for pigmentation secondary to Quinolones.

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Dr. Mona Abdel-Halim

Posted

Yes type II minocycline induced pigmentation is also my thought

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vincenzo polizzi

Posted

Mynocycline induced pigmentation isn't usually a fibrous histiocytoma-like lesion...but I think you all are right, so I'm asking myself if it could be an odd mynocicline induced reaction on a preexisting histioid leprosy..

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Guest Michelle Liang

Posted

Hi everyone! I've been stalking this site as I'm preparing for my ICDP exam. I was thinking of hemosiderotic dermatofibroma as well, but not sure about the last 2 stains. Minocycline induced pigmentation would be consistent with Perl's and Fontana Masson positivity but am puzzled as it should not present clinically similar to a dermatofibroma.

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Dr. Richard Carr

Posted

Welcome Michelle. Please do post your suggestions and don't just stalk!  Good luck with your exam.

Siderotic DF for me but of course I never considered the other suggestions.  It is a bit odd looking though. If we have any other stalkers please post your thoughts too!  I believe you only need to register with the site to have posting rights.

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vincenzo polizzi

Posted

Welcome on board Michelle and break a leg with your exam.

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Dr. Hafeez Diwan

Posted

Minocycline pigmentation.  Both melanin and iron stains are positive.

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Dr. Mona Abdel-Halim

Posted

Welcome Michelle, good luck with ur exam. I just want to tell u that this site helped me a lot on my preparation for the ICDP. Do not hesitate, just write ur thoughts. We all are learning from each other... I encourage you to go for membership so as to be able to see all the archived cases... U should not miss that :-))

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Guest Michelle Liang

Posted

Thanks everyone! Yes Mona, I am a member and have been ploughing through the amazing archives

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