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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 1748 - 8 February - 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: 46 year-old female with a skin lesion on her left arm.

Case Posted by Dr Hafeez Diwan


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Admin_Dermpath

Posted

Dr Hafeez Diwan has a nice puzzle of a Spot Diagnosis Case for you today.

 

Geoff Cross - DermpathPRO Projects

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vincenzo polizzi

Posted

Difficult case that needs more CPC. It seems a mixture of chilblains ( lymphocytic vasculitis ) SLE ( dermal mucinosis and periadnexal lymphoid infiltrate and interface vacuolar dermatitis ) and drug reaction ( eosinophils). 

So my first thought is a drug associated Subacute Lupus Erythematosus. 

 

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Raul Perret

Posted

I thought of arthropod bite vs early dermatitis herpetiformis lesion. IF as well as cpc are important here. For me some early flame figures are present in pic 8

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Raul Perret

Posted

Of course I Agree with Vincenzo in that drug eruption must always be considered in the differential of most inflammatory dermatosis. Mainly if eosinophils are present!

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Robledo F. Rocha

Posted

I got the same impression of Raul that this could be a lesion caused by insect bite, but once plasma cells are rare in such hypothesis, I favor erythema migrans of Lyme disease. Drug eruption is a diagnostic possibility as well.

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I go with arthropod bite reaction, which can presents with intersticial mucin deposition, and drug reaction. CPC is needed.

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Nitin Khirwadkar

Posted

Agree with differentials above. Would favour drug induced lupus.

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Dr. Hafeez Diwan

Posted

This was an insect bite reaction in a patient with lupus.

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