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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 1484- 02 March 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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Case History: 56 year-old male with biopsy of bullous lesion from left lateral trunk.

Case posted by Dr Hafeez Diwan


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Raul Perret

Posted

Probably Adult linear IgA bullous dermatosis (if the immunofluorescence is for IgA demonstration). Maybe the patient received Vancomycin...

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Nitin Khirwadkar

Posted

Agree. The differentials on the H&E are those of a sub-epidermal blistering disorder with neutrophils. Would add bullous SLE to the differential. Not sure what the linear deposition is on the direct IMF.

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Pemphigoid and epidermolysis bullosa acquisita can both be neutrophil-rich (if the IMF is IgG or C3). 

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vincenzo polizzi

Posted

Agree with Abdul! And (if the IMF is IgG or C3), in img5 top, the deposit seems on the dermis side. Probably EBA...But it need know what is the ab ( IgA or IgG or C3?)

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Dr. Mona Abdel-Halim

Posted

Agree with the discussion above
We need to know what is the IF?!

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Arti Bakshi

Posted

yes, we do do need to know the IMF...probably linear IgA.

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Guest Romualdo

Posted

I meant, agree with adult linear IgA bullous dermatosis.

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Dr. Richard Carr

Posted

Should we also consider anti-P200 pemphigoid? Rare, linear IgG & C3 along the dermal side and histologically has neutrophils.  Clinically looks like bullous pemphigoid.

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vincenzo polizzi

Posted

Yes, the suggestion of Dr Carr is the more consistent with clinical and pathology of this case...unfortunately don't know this new pathological chapter...so i will study it

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Dr. Hafeez Diwan

Posted

The IF is IgA.  IgG and C3 were negative.  So I called it Linear IgA bullous dermatosis.

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