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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 1651 - 24 October 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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The patient is a 59 year old man with a history of male pattern baldness with a recent onset of acute telogen effluvium. A punch biopsy is taken from the left posterior crown of the scalp for hair biopsy. Clinical Diagnosis: alopecia.

Case Posted by Dr Mark A Hurt


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Mark A. Hurt MD

Posted

Note to my “Spot” colleagues:  It has been a genuine pleasure working with all of you over the years, and I thank Iskander especially for his counsel and his confidence in me.  I hope you have learned as much from me as I have from you.

With all best regards to you, as I sign off….

MAH

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Found this below that I hope could be pertinent:

Primary systemic amyloidosis causing diffuse alopecia by telogen arrest.

Hunt SJ, et al. Arch Dermatol. 1991.
 

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Nitin Khirwadkar

Posted

Agree, systemic amyloidosis causing TE. Any manifestations of FA polyneuropathy?

 

Many thanks Dr Hurt for your contribution to this wonderful website. Your cases, every Monday, and the prompt answers, along with discussions, will be missed.

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Dr. Mona Abdel-Halim

Posted

Yes, systemic amyloidosis causing TE... Marvelous case...

Thank u so much Dr Mark for your wounderful contribution to the website, you will be missed.. 

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Arash Daryakar

Posted

Agree with colleagues,Telogen effluvium caused by systemic amyloidosis .

Dear Dr Hurt: Thank you so much for your educational cases.By the way if possible please visit website and comment on the cases sometimes!

 

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Arti Bakshi

Posted

Wow, what a case!!..agree with comments above

Really sorry to see Dr Mark Hurt go! Have learnt so much from him and will surely miss his superb cases (with great photography), educational comments and  balanced viewpoint. Thank you so much.

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Raul Perret

Posted

Agree alopecia secondary to amyloid deposits for clinical correlation. 

I join the rest of my colleagues, thank you very much Dr. Hurt for the teachings and the willingness to answer our questions. Maybe you will have time for commenting once in a while as Arash suggested. 

Have a good day

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vincenzo polizzi

Posted

Dear Dr Mark

I had studied many times the skin tumors and lesions ( above all adnexal skin lesions ), but I have begun to truly know them thanks to your comments. For this I will feel the lack of a master like you. Thank you so much!!!

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Eman El-Nabarawy

Posted

What a wonderful case! Agree with the colleagues. 

 

Thank u so much Dr Mark. I have learnt a lot. Really I am grateful.

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Thank you Dr Mark, I learned a lot these years thanks to you and all of the collegues here.

Agree with the above comments.

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Mark A. Hurt MD

Posted

Thanks to all of you, again, for everything....

 

My diagnosis is below:

 

SCALP BIOPSY :

-- PRIMARY SYSTEMIC AMYLOIDOSIS, WITH DIFFUSE ALOPECIA

COMMENT:  In 1991, Hunt et al published the findings of a patient with a similar pattern of alopecia.  The difference in their patient was that they noted that the follicles weren't completely destroyed by amyloid, which is what I see in the alopecia in this particular biopsy.  There is no significant scarring in the specimen.  Given the diffuse and dramatic deposition of amyloid in this biopsy, I suspect that further clinical work up needs to be considered for the patient, if appropriate.

 

 

 

 

 

 

Reference

 

 

 

Hunt SJ, Caserio RJ, Abell E. Primary systemic amyloidosis causing diffuse alopecia by telogen arrest. Arch Dermatol. 1991 Jul;127(7):1067-8. PubMed PMID: 2064414.

 

 

 

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