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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 1493- 15 March 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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Case History: 30 year old woman with history of Wegener’s granulomatosis now with firm erythematous nodule with central dell on elbow.

Case posted by Dr Uma Sundram


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Dr. Mona Abdel-Halim

Posted

Interstitial granulomatous dermatitis (palisaded neutrophilic and granulomatous dermatitis). Typical clinical presentation also.

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Raul Perret

Posted

Completely agree with mona palisaded neutrophilic and granulomatous dermatitis. However, I would perform special stains for microorganisms before this diagnosis

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Agree.  Palisaded neutrophilic and granulomatous dermatitis. 

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vincenzo polizzi

Posted

I see a perforating palisaded necrobiotic granuloma, with neutrophils nuclear dust and histiocytes. I thought of a granuloma annulare ( single lesion ), or rheumatoid nodule or....but ultimately the Mona's dg fits better with the clinic history and the pathological features. Agree with Interstitial Granulomatous Dermatitis.

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Nitin Khirwadkar

Posted

Agree with PNG dermatitis

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Guest Romualdo

Posted

More than interstitial infiltrate I see a large necrobiotic focus sorrounded by palisaded histiocytic infiltrate. I think this is perforated juxta-articular granuloma annulare.

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Arti Bakshi

Posted

Palisaded and neutrophilic granulomatous dermatitis.

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Uma Sundram

Posted

You guys nailed it. Palisaded and neutrophilic granulomatous dermatitis.

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Very good thoughts. But I also wonder, could this be reactive perforating collagenosis? The clinical description sounds like it.

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