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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 1529 - 04 May 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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6-day-old healthy full-term Hispanic girl presents with an ulcerated lesion on the left upper arm. It was present at birth as a “red dot” and began to crust on day of life 3. She was sent to the ER by the PCP who was concerned it could be HSV.

Dr Hafeez Diwan


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vincenzo polizzi

Posted

Solitary congenital self-healing(i hope) Langherans cell histiocytosis

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Guest Arash Daryakarr

Posted

congenital self healing histiocytosis vs LCH

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Raul Perret

Posted

I agree with the differentials mentioned above as we can see an apparently congenital lesion that ulcerates the skin, with some eosinophils and lymphocytes, numerous epithelioid cells. I would remark only that the cells look quite atypical for me, some even a bit rhabdoid and there is necrosis (that can be seen in disorders of Langerhans cells but I think is not that frequent). So based on this I would widen a bit the IHQ pannel in order to rule out an extrarrenal rhabdoid tumor (can rarely be congenital) and rhabdomyosarcoma (I think this is less likely)

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vincenzo polizzi

Posted

I think the cells look a bit atypical but also look mostly Langerhans cells..so i would have to think to a LC-sarcoma, but the cells aren't so atypical. The lesion is locally aggressive, but the clinical is good. So i favour the diagnosis of solitary congenital LCH.

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Nitin Khirwadkar

Posted

Congenital (self healing) reticulohistiocytosis/LCH

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Guest Romualdo

Posted

Congenital self-healing reticulohistiocytosis (Hashimoto-Pritzker disease).

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Dr. Hafeez Diwan

Posted

Indeed.  Congenital self-healing reticulohistiocytosis. 

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