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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 1648 - 19 October 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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75 year-old male with biopsy from left medial ankle.

Case Posted by Dr Hafeez Diwan


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Admin_Dermpath

Posted

A nice case from Dr Hafeez Diwan, the first of his two for this week.

Cheers, Geoff

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vincenzo polizzi

Posted

First thought glomeruloid hemangioma, but really not sure... 

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Dr. Mona Abdel-Halim

Posted

I think we have vascular thrombosis (best visualized in the last image), so I am thinking of reactive angioendotheliomatosis secondary to some sort of vsculopathy. CPC is mandatory.

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vincenzo polizzi

Posted

I was thinking of a thrombotic vasculopathy now, cryoglobulinemy-like...

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So many different pathologies! I was thinking of a vasculitis because I can see luminal and mural thrombi, focal mural infiltration by inflammatory cells and neutrophilic intersticial infiltration accompanied by some leukocytoclasis. The epidermis is also ulcerated, and that may be secondary to the vasculitis. CPC is needed.

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Raul Perret

Posted

I do not see all the criteria for considering this a vasculitis I think this is a case of reactive angioendotheliomatosis due to a thrombotic pathology as Mona suggested

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vincenzo polizzi

Posted

I don't see the capillary-venous fibrin degeneration of LV but rather thrombotic organised material with a glassy appearance, like type I cryoglobulinemia. And an interstitial and perivascular granulocytic infiltrate as inflammatory reaction to vasculopaty. 

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Eman El-Nabarawy

Posted

Reactive angioendotheliomatosis secondary to vasculopathy for clinical correlation. 

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