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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 2097 - 20 June 2018 Posted By: Dr. Hafeez Diwan

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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68 year-old female with lesions on the left hand and left leg. This biopsy is from the left leg.


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Agree. Since the dermis appears to be completely involved by this palisading granulomatous process (no uninnolved dermis at all) and the process seems to be in layers, I would throw in necrobiosis lipoidica in the differential diagnosis. GA rarely involves the whole dermis, usually there are relatively uninvolved spots in the dermis.

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Dr. Hafeez Diwan

Posted

This is a diabetic patient.  Necrobiosis lipoidica diabeticorum.

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Alice Roberts

Posted

Leaning toward interstitial GA and fits better with hand lesion.  However, NLD in differential and would speak to clinician.

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Alice Roberts

Posted

Ah, I see answer given! Hand lesion red herring?

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