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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 1574 - 07 July 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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22/M, scalp biopsy. Marked perifollicular erythema ?folliculitis decalvans ?lichenplanopilaris

Dr Arti Bakshi


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sfwenson

Posted

I'm guessing Langerhans cell histiocytosis.  Need IHC, though.

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Guest Arash Daryakarr

Posted

I think of LCH ,too. CD1a will help.

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vincenzo polizzi

Posted

Agree with Above!!!

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vincenzo polizzi

Posted

Nice and typical clinical presentation with an infectious like pattern on the scalp.

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Dr. Mona Abdel-Halim

Posted

Folliculocenteric LCH, marvelous case :-)

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Arti Bakshi

Posted

Yes this is folliculocentric langerhans cell histiocytosis. It is quite an unusual pattern of LCH as most localised forms of LCH show diffuse demal infiltrate of Langerhans cells and present as solitary nodule or papules. This case had an exclusive folliculocentric pattern and hence the clinical impression of ?folliculitis decalvans ?LPP...the histological diagnosis came as quite a surprise to the dermatologists. The patient has no other lesions and is well otherwise. See link below for a strikingly similar case report. http://www.ncbi.nlm.nih.gov/pubmed/15024194

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Arti Bakshi

Posted

Yes this is folliculocentric langerhans cell histiocytosis. It is quite an unusual pattern of LCH as most localised forms of LCH show diffuse demal infiltrate of Langerhans cells and present as solitary nodule or papules. This case had an exclusive folliculocentric pattern and hence the clinical impression of ?folliculitis decalvans ?LPP...the histological diagnosis came as quite a surprise to the dermatologists. The patient has no other lesions and is well otherwise. See link below for a strikingly similar case report. http://www.ncbi.nlm.nih.gov/pubmed/15024194

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Arti Bakshi

Posted

Yes this is folliculocentric langerhans cell histiocytosis. It is quite an unusual pattern of LCH as most localised forms of LCH show diffuse demal infiltrate of Langerhans cells and present as solitary nodule or papules. This case had an exclusive folliculocentric pattern and hence the clinical impression of ?folliculitis decalvans ?LPP...the histological diagnosis came as quite a surprise to the dermatologists. The patient has no other lesions and is well otherwise. See link below for a strikingly similar case report. http://www.ncbi.nlm.nih.gov/pubmed/15024194

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