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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 2094 - 15 June 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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M40. Purple plaque on shin, 2 years.


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The main pathologic process here is nodular fibrosis associated with leukocytoclastic vasculitis. So I would consider erythema elevatum diutinum. The other possibility is my favorite entity localized chronic fibrosing vasculitis, which I don't know what it is. I have one case with morphology of localized chronic fibrosing vasculitis but with increased plasma cells. The patient also had masses in the lungs which similar histologic features. I did IgG4 and there are significant increase of IgG4 plasma cells so I suspect some cases of localized chronic fibrosing vasculitis might be a form of localized IgG4 sclerosing disease.

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dermpath1

Posted

Sclerotic fibroma may be born from EDD or benign fibrous histiocytoma.

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vincenzo polizzi

Posted

Agree with EED. Nice onion skinning perivascular fibrosis. 

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Dr. Richard Carr

Posted

This was a spectacular case of erythema elevatum diutinum (also suggested clinically!).

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Dr. Mona Abdel-Halim

Posted

Beautiful! EED was my thought too.

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