Jump to content
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 1536 - 13 May 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)

Patient itchy and picked off pieces of skin placed in wet tissue and brought in for microscopic examination. ? lice/ticks.

Dr Richard Carr


  Report Record

User Feedback


Raul Perret

Posted

I see fragments of epidermis with autolysis, haemorrage and presence of some exogenous material filamentous (probably related with the wet tissue that the patient used, was it blue and white?). No clear evidence of lice or tick for me and neither an inflammatory reaction. Is it a psychiatric patient?  

Share this comment


Link to comment
Share on other sites

Arti Bakshi

Posted

Probably delusional parasitosis

Share this comment


Link to comment
Share on other sites

vincenzo polizzi

Posted

I see fragments of eosinophilic jalinic degenerated tissue, cement-like in fig5/7, and something lucid in fig 8, both reminiscent ( but t's very difficult for me and am not sure ) of attachment mouthpart of a Tick...

Share this comment


Link to comment
Share on other sites

Nitin Khirwadkar

Posted

Delusional parasitosis. The history is quite suggestive.

Share this comment


Link to comment
Share on other sites

IgorSC

Posted

Agree with the diagnosis. Delusional parasitosis. Once I had a case like this, the patient brought the material in a box and it was almost only keratinized material and debris crusts.

Share this comment


Link to comment
Share on other sites

Dr. Richard Carr

Posted

Yes these are fragments of skin that the patient has vigorously removed under the false impression that they have parasites (delusional parasitosis). The history of bringing in material, often in tissue paper, is also typical. We can see a few blue coloured cotton fibres here.  Management relies on trying to gain a rapport with the patient whilst not being to confrontational. A pathology report indicating that careful examination failed to detect any evidence of parasites may be helpful.

Share this comment


Link to comment
Share on other sites



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...