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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 1970 - 18 Dec 2017 Posted By: Limin Yu

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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23 female, perineum
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Edited by Admin_Dermpath

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Anil Patki

Ulcerated epidermis with irregular acanthosis and inward-turning rete pegs; steel grey nuclei of keratinocytes and a lot of inflammation. Looks like genital wart (condyloma acuminata) treated with imiquimod or chemical cauterization

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Raul Perret

Raul Perret 262

Posted

Agree with Vincenzo I also thought of Syphilis

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anh

Agreed. PAS for fungal microorganisms and Warthin-Starry or IHC for Syphilis.

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Limin Yu

Thank you all for the insightful discussion.  It's syphilis. It was confirmed by immunostain - I wish I could share the image here. The file size limit of 0.11 MB in  attachment prevents me from doing so. 

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