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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 1744 - 2 February - Dr Arti Bakshi 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: 50/F, Scaly rash on scalp.

Case Posted by Dr Arti Bakshi


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Admin_Dermpath

Posted

Another beautiful set of images from Dr Arti Bakshi

 

Geoff Cross - DermpathPRO Projects

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vincenzo polizzi

Posted

Psoriasiform and spongiotic dermatitis with a parakeratotic scale crust at lip of infundibular ostium is consistent with seborrheic dermatitis. 

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Raul Perret

Posted

beautiful pictures of clear cut seborrheic dermatitis. I think a PAS stain is always important to indicate presence/absence of fungi

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Seborrheic dermatitis (SD). The absence of sebaceous gland could be a tricky finding and someone could call this Psoriasis, but chronic SD can also present with sebaceous gland atrophy.

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Arti Bakshi

Posted

Yes, seborrhoeic dermatitis. Clearly, too easy for the bunch above!

I put it in for trainees and newbies as have often seen trainees (and many general pathologists) missing this distinctive pattern and labelling biopsies as just spongiotic dermatitis/eczema. The perifollicular parakeratosis is  a typical finding. Also remember seborrhoeic dermatitis is one of the subtypes of of eczematous reaction, where one can see neutrophil exocytosis and therefore can be misdiagnosed as psoriasis. Igor's point is also valid in this regard.

Thanks for all your comments!

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