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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 1741 - 30 January - Dr Limin Yu 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: This is a 37 yo F with sudden onset of papules.

Case Posted by Dr Limin Yu


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Admin_Dermpath

Posted

Start your week off with a neat case from Dr Limin Yu.

 

Geoff Cross - DermpathPRO Projects

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Dr. Mona Abdel-Halim

Posted

Pityriasis lichenoides spectrum. Sudden onset favors PLEVA if supported clinically by presence of necrotic lesions.

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vincenzo polizzi

Posted

Agree. I guess the large hypercromic lymphocytes are CD30 cells...

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Robledo F. Rocha

Posted

A hard case! Clinical history favors the acute form of pityriasis lichenoides, but caught my eyes the absence of extravasated erythrocytes and vacuolar change of the basal layer, and the presence of periadnexal lymphocytic infiltration. Were the lymphocytes abnormal and large, I’d go with lymphomatoid papulosis with 6p25.3 rearrangement due to the presence of, at low power magnification, pagetoid reticulosis-like epidermotropic lymphocytic infiltration and marked involvement of pilosebaceous units and eccrine glands.

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Arti Bakshi

Posted

Good suggestion by Robledo! Definitely need a CD30 in this case. However, PLEVA and LyP lie on a spectrum and one can get CD30+ cells in PLEVA. The clinical course of the disease would be important in the distinction.

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I think this is PLEVA, but I liked Robledo´s idea.

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Raul Perret

Posted

I thought of PLEVA in this case as all of you guys suggested. My impression was that we see some extravasated erythrocytes (although not super prominent)

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Nitin Khirwadkar

Posted

I am thinking of PLEVA. As Raul has commented, I too feel there is some RBC extravasation.

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I think the invading lymphocytes are atypical and there is ulceration. I would go for lymphomatoid papulosis but clinico path correlation required.

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Guest parasa gayatri devi

Posted

I am thinking of PLEVA.  Focal loss of stratum corneum and spongiosis favour the diagnosis of PLEVA

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You guys are awesome. Agree with respect!  This is a PLEVA. Your points are well taken!

 

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