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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 2122 - 27 July 2018 Posted By: Dr. Richard Carr

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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M70. 3 yrs history of laxity/pigmentation (L) temple/(L) lateral eyebrow. Slowly got worse. Background solar elastosis. ?Localised cutis laxa, ?other.

Edited by Admin_Dermpath


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Anil Patki

Posted

Clinical picture is of hypothyroidism. Histology supports it by showing mild hyperkeratosis, follicular plugging ( reflection of xerosis) and mucin in the dermis.

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Looks like there is patchy loss of elastic fibers. Elastic stain? 

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Admin_Dermpath

Posted

Some extra images added for a further clue.

Admin

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Anil Patki

Posted

Thickened, coarse elastic fibres and solar elastosis at the typical site - Favre-Racouchot syndrome.

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Agree with FRS. 

2 hours ago, Anil Patki said:

Thickened, coarse elastic fibres and solar elastosis at the typical site - Favre-Racouchot syndrome.

Agree. Multiple comedones also. 

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Alice Roberts

Posted

Mid dermal elastolysis is unusual on the face. However, I think the EVG stain supports this diagnosis.  There is only one comedone.  The clinical picture is suggestive of comedones but not sure.  I look forward to the answer!

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Raul Perret

Posted

I have to say that my first impression was FRS, but not sure about it

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Dr. Richard Carr

Posted

Thanks. Based on CPC I favoured acquired & localised cutis laxa (loss of elastic in the mid/upper dermis). Think FRS is a reasonable suggestion although the anatomic location would be odd (including swelling of the outer brow).

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