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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2041 - 03 April 2018 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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25 year old man with HIV and new itchy, orange patch on back. On multiple medications.
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Go to records April 2018

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Anil Patki

Anil Patki 4

Posted

Dermal lymphocytic infiltrate and extravasation of RBCs and an orange colour clinically seen suggest lichen aureus. The clue that the patient is on multiple drugs also suggests a drug-induced pigmentary purpura.

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vincenzo polizzi

vincenzo polizzi 185

Posted

A patched lesion of KS could simulate a purpuric dermatitis...couldn’t it?  I know the back isn’t an usual site, but would like to see a HHV8 stain. 

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Uma Sundram

Uma Sundram 169

Posted

Perfect. You guys thought of all the correct possibilities. 

Lichen aureus. HHV8 is negative. The drug induced PPE is also a good thought; the clinician thought this was classic for lichen aureus, just in an HIV+ individual. 

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

Beautiful images. agree with lichen aureus

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