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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 2017 - 28 Feb 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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11 year old male with lesion of 1 year duration. Solitary ivory plaque, 1.5 x 1 cm in size, on lateral right neck. Not itchy, no prior trauma, no other lesions.


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Epidermal atrophy, hydropic degeneration of the basal cells, upper dermal edema and lichenoid infiltrate all point towards LSA. Clinical features are also supportive.

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vincenzo polizzi

Posted

Folliculotropic MF is often a solitary lesion. Syringotropism is also usually observed. 

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A valid point Vincenzo. But epidermotropism has been described in lesions of LSA

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Uma Sundram

Posted

We struggled with this one a little bit. The deep infiltrate was unusual for LSA (or LS, since sometimes we don't see atrophy) although I agree a lot of the other features of LSA are present. The presence of adnexotropism caused some concern for connective tissue disease. We eventually came down on (perhaps) LS/morphea overlap syndrome, with request to look out for other features of connective tissue disease upon follow up (i.e., if the patient has new lesions, these should be biopsied so we understand the disease process better). Agree with Anil that epidermotropism has been described in LS.

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