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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 2113 - 12 July 2018 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Male, 56 years old, Right occipital area of scalp: Non-scarring alopecia- inflamed


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Anil Patki

Posted

This is a non scarring alopecia. The sebaceous glands are well preserved. The lymphocytic infiltrate surrounding the follicles is at a deeper level and looks like a swarm of bees. I think this is alopecia areata

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John Zhang

Posted

I favor allopecia areata based on peribulbar inflammation, increased catagen hair, small caliber hair ("nanogen hair"?). In one area the lymphocytic infiltrate is rather exuberant, makes me wonder for lupus. But I favor AA.

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I can see a dense inflammatory infiltrate surrounding the adnexa in the isthmus along with a swarm of bees at the bulbus. At first, I thought this was AA, but with this dense superficial infiltrate I think we should consider the possibilities of Syphilis and the non-scarring alopecia of the systemic LE. Clinical data and immunostais for treponema and CD123 can be of great help.

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