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?

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Case Number : Case 2046 - 10 April 2018 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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62 year old woman with vulvar rash.

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User Feedback


Anil Patki

Posted

I think there's epidermotropism with two types of cells seen in the epidermis- lymphocytes and monocytes with elongated nuclei. Would like to rule out Pagetoid reticulosis.

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vincenzo polizzi

Posted

Agree with LSA, inflammatory phase. In this phase scattered lymphocytes are found at the dermal-epidermal interface and above it, however they don’t form clusters. No atypical lymphocytes and the intraepidermal ones show the same size of intradermal

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IgorSC

Posted

Lichen sclerosus histologically mimetizing MF.

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Uma Sundram

Posted

Perfect. I also thought LS. I would leave an unusual lichen planus and lichenoid contact dermatitis in the differential. Also agree that MF is not favored; the clinical also did not fit for MF. LS and LP are both known to be positive for clonality assays so those should be used with caution.

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