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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 1859 - 13 July - Dr 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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47 year-old male with erythematous, pruritic rash all over the body, including palms, soles, and scrotum. This biopsy is from the thigh.

Edited by Admin_Dermpath


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urmilapandey

Posted (edited)

psoriasiform changes, i can see granular layer in some areas: ?early psoriasis. have heard there is something called granular parakeratosis (being a generalist, only hear/read about these things!)..

also, some interface like changes in image 5...?

Edited by urmilapandey

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Dr. Mona Abdel-Halim

Posted

CPC is important, thinking of psoriasiform drug reaction. 

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Saman Fatah

Posted

There is an alternating orthokeratosis/parakeratosis with a possible hyperkeratosis within/around the follicular ostium. I wounder this could be a Pityriasis Rubra Pilaris (PRP) especially with a clue of palmoplanar involement from the history and right age for the onset of Adult variant.

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Anil Patki

Posted

No Munro's microabscesses. DD- Psoriasis under treatment, psoriasiform drug rash, psoriasiform secondary syphilis

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Robledo F. Rocha

Posted

Dilated tortuous capillaries in dermal papillae make me favor psoriatic erythroderma.

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Nitin Khirwadkar

Posted

Agree with the differentials. Favour psoriatic erythroderma due to the well developed ' vascular papilla'.

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Mariantonieta Tirado

Posted

Agree with Psoriasis and PRP (the pattern of parakeratosis is good for this) as differential. Didn't see epidermotropism. 

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Dr. Hafeez Diwan

Posted

Psoriasis.  The patient is HIV positive.

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