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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 1798 - 19 April - Dr Hafeez Diwan 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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Clinical History: 89 year-old female with biopsy of rash on left inner labium majus.

Case Posted by Dr Hafeez Diwan


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Admin_Dermpath

Posted

I am away for the next couple of days so am posting Dr Hafeez Diwan's excellent case a day early.

 

Cheers, Geoff Cross - DermpathPRO Projects

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Robledo F. Rocha

Posted

Acantholytic epidermal basal cells attached to dermal papillae, looking like a tombstone row or small intestine villi. Whereas the clinical presentantion is not flaccid blisters or erosions, but a rash, I go with urticarial pemphigus vulgaris.

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vincenzo polizzi

Posted

PV is a good differential! But I don't see any adnexal involvement and clinical description seems point at localised rash. 

How about a "papular acantholytic dermatosis of the genitocrural region"?

This is usually HH-like, but clinically could fit very well.

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My first hypothesis wal also genital papular acantholytic dermatosis. A DIF may be of great help to differentiate it from PV.

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Dr. Mona Abdel-Halim

Posted

Good posibility Vincenzo !!

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Raul Perret

Posted

Also thought of acantholytic dermatosis of the genitocrural area due to the clinical information and the localized aspect seen on the biopsy. Also, agree that IF could help.

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Sasi Attili

Posted

Acantholytic dermatosis of the genitocrural region would be my first guess. But Hailey- Hailey, PV etc are in the differential. CPC/ DIF would help.....

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Dr. Richard Carr

Posted

Suprabasal without dyskeratosis or HH-like pattern. I'd have suggested in keeping with pemphigus, IMF studies needed to confirm though.

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Dr. Hafeez Diwan

Posted

Acantholytic dermatosis of genitocrural region.

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