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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.
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23 female, perineum

Edited by Admin_Dermpath


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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

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Agree with Vincenzo I also thought of Syphilis

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

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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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