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?

Sign in to follow this  

Case Number : Case 2049 - 13 April 2018 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

25 year old Female Papular rash arms 6/12 ago. Spread to abdomen, legs, upper back. Asymptomatic. 3.5mm diameter excoriated papules

Sign in to follow this  

User Feedback


Anil Patki

Posted · Report

I think that this is a case of follicular lymphomatoid papulosis. Since it shows a wedge shaped infiltrate and epidermotropism, it may alternatively be called LyP with overlapping type A and B features

Share this comment


Link to comment
Share on other sites
vincenzo polizzi

Posted · Report

Before IHC images I was thinking of PLEVA or some odd Pagetoid Reticulosis ( 6 month is a long interval time for LyP-lesional-regression..., and didn't see any large atypical intradermal cell ), but CD30 remark many large intrafollicular cells and too many intraepidermal cells, so I agree with Anil: Type F Lymphomatoid Papulosis. 

Share this comment


Link to comment
Share on other sites
Dr. Mona Abdel Halim

Posted · Report

Same here, first though was PLEVA then I think with the CD30, it is LyP

Share this comment


Link to comment
Share on other sites
Dr. Richard Carr

Posted · Report

Nice "controversial" case. I'd stick with PLEVA. By coincidence had e-mail correspondence with Werner Kempf about distinguishing LyP type D (epidermotropic) from PLEAVA with CD30+ve cells bottom line appeared to be it can be impossible. I might send Werner the link to the case.

Share this comment


Link to comment
Share on other sites
Arif Usmani

Posted · Report

Probably a reactive CD30+ inflammatory response, favor PLEVA

Share this comment


Link to comment
Share on other sites
Dr. Richard Carr

Posted · Report

Dear Richard

Thank you so much for the link to this great case. ......

Based on the cytomorphology of the cells, the extent of vacuolization, the erythrocyte extravasation, the number of apoptotic keratinocytes as well as the number of neutrophils in the hyperparakeratosis I favor CD30+ PLEVA in this case. The clinical presentation seems to me compatible with PLEVA. Clonality studies do not help in this situation as PLEVA harbors clonal T-cells in up to 60% of the cases. The course and the lack of scar formation could help. 

Warm regards

Werner Kempf

Share this comment


Link to comment
Share on other sites


Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now