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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 1768 - 8 March - 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: Biopsy of a “skin plaque” on right ankle of 42 year-old male.

Case Posted by Dr Hafeez Diwan

Edited by Admin_Dermpath


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vincenzo polizzi

Posted

A challenging case. I'm torn between something like interstitial granulomatous dermatitis, but I don't see any convincing floating collagen sign...and a patch stage of KS, but no convincing promontory sign...

In fig 3 there is a cytoplasmic vacuole that makes me favor a verrucous variant of Kaposis Sarcoma. 

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Mariantonieta Tirado

Posted

Vascular lesion. Agree with possible Kaposi. I see subtle slit vascular lumina, hemosiderin, hemosiderophages. D240, CD31 and HHV8 would be helpful

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Dr. Richard Carr

Posted

Agree this is a difficult case.  I had a few thoughts but top considerations for me were lipodermatosclerosis and KS.

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Raul Perret

Posted

Im glad I was not the only one finding this case challenging. After spending a bit of time my impression was Kaposi

 

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Josie Bisi

Posted

I see a vascular lesion, with clefts between collagen bundles, and hemossiderophages. I cannot see promontory sign. I think it's a kaposi sarcoma. I would ask for IHC CD31 and HHV-8. 

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Nitin Khirwadkar

Posted

I would go for a Kaposi's sarcoma.

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Dr. Hafeez Diwan

Posted

Kaposi sarcoma.  I left out some information.  The patient is HIV positive, with a CD4 count of 8.  HHV-8 was positive.

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