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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 1861 - 16 July - 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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51 F scalp lesion, clinical impression: psoriasis.


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Anil Patki

Posted

Suprbasal acantholysis extending into a hair follicle, nice tombstone appearance, Pemphigus vulgaris

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vincenzo polizzi

Posted

Agree with above. Nice follicular extension of acantholisis. 

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Robledo F. Rocha

Posted

Pemphigus vulgaris with an unbelievable suprabasilar acantholysis extending deep down to the follicular infundibulum.

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Raul Perret

Posted

Agree with the pattern description of the colleagues, probable PV to confirm with immunofluorescence

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Saman Fatah

Posted

Pattern is very suggestive of PV "textbook example", correlation with DIF finding +/- ELISAs for DSG1/DSG3 is essential to firm up such diagnosis including evidence of mucosal involvement (though the latter can rarely be spared in PV).

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Limin Yu

Posted

This is a PV!  Thank everyone for the discussion. The patient did have mucosal involvement. DIF was performed at an outside institute. I will update its results once it's available to me. 

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Limin Yu

Posted

DIF showed intercellular deposit of IgG and C3 in the epithelium of the lip, confirmatory of PV. Thanks!

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