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 2090 - 11 June 2018 Posted By: Limin Yu

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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63 year old male with lesion on arm.


User Feedback


Anil Patki

Posted

Subepidermal clevage with necrotic epidermis and dermal 'silence' . The only condition that comes to my mind is toxic epidermal necrolysis

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vincenzo polizzi

Posted

A single lesion of TEN?  Is it possible? Histologically full agree with Colleagues. 

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The histologic changes are in the spectrum of EM/TEN/SJS. Clinically this lesion was more compatible with EM.

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My first thought was TEN. I am glad that we are all on the same page and Dr. Yu gave us the final answer which is consistent with what we thought. But I also want to comment that these histologic features are not pathognomonic for TEN. I believe that the epidermal necrosis can happen in any old blister. Therefore cell poor BP can show similar features like those in this case, and PCT cannot be excluded.

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Dr. Richard Carr

Posted

Actually here we see rounded pink bodies in the epidermis which is typical for individual cell necrosis (rather than coagulative) which is the clue for the diagnosis.

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