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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 1447- 11 January Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)
Case History: The patient is a 79-year-old white man with punch biopsies of non-pruritic erythematous papules, some of which are ulcerated, present for two months. The biopsy was taken from the left upper inner forearm.
Case posted by Dr Mark Hurt
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  Report Record
Go to records January 2016

User Feedback


Nitin Khirwadkar

Nitin Khirwadkar 63

Posted

Pityriasis lichenoides. The biopsy shows a mixed tissue reaction pattern (spongiotic and interface), occasional necrotic keratinocytes, some red cell extravasation and a lymphocytic vasculitis.

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Raul Perret

Raul Perret 262

Posted

It looks like a lichenoid pattern of reaction with parakeratosis, apoptosis at all levels of epidermis with satellite cell necrosis (picture 4)  basal hydropic degeneration, and a dermal lymphocytic perivascular infiltrate without eosinophils. Made me think in first place of Graft vs Host disease but clinical correlation is critical and differential wide.

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Arti Bakshi

Arti Bakshi 286

Posted

Agree with Nitin...PLC/PLEVA spectrum. The clinical would suggest more 'acuta' than 'chronica'.

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Yes Pityriasis Lichenoides, mostly acuta due to the presence of ulcerated lesions.

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Guest Romualdo

Guest Romualdo

Posted

Agree with pityriasis lichenoides, most probably PLEVA.

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vincenzo polizzi

vincenzo polizzi 185

Posted

I see an alternating orto parakeratosis PRP-like, but clinical and many histological findings convince me ti PLEVA

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