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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 2078 - 24 May 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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Left cheek incision biopsy.

Edited by Admin_Dermpath


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Chillblain or lymphoid hyperplasia

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vincenzo polizzi

Posted

CD31?HHV8?  Angiosarcoma is my first thought. 

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Anil Patki

Posted

Superficial and deep dense perivascular and periadnexal infiltrate of lymphocytes and ?  mucin in upper dermis. I think this is lupus tumidus. Cutaneous lymphoid hyperplasia is the second possibility which can be ruled out by clinical correlation.

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vincenzo polizzi

Posted

I'm better watching this case on my computer, and agree with Anil comment. 

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Dr. Richard Carr

Posted

I would favour Jessner's which some regards as a variant of lupus. I am assuming the infiltrate is mainly T-cells of course (if not would have to re-consider).

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Admin_Dermpath

Posted

Dear all,

Some good guesses here so I've included full observations/diagnosis below:

In the dermis there is a superficial and deep, light perivascular and to a lesser extent periadnexal chronic inflammatory cell infiltrate. Basement membrane thickening and mucin deposition are not appreciable (DPAS negative). There are no fungal hyphae on special stains. The main histological differentials are Jessner's lymphocytic infiltration of skin, tumid lupus erythematosus, lymphocytoma cutis, and polymorphous light eruption.
The features are those of a superifical and deep perivsacular dermatitis; and in the right clinical context are in keeping with Jessner's lymphocytic infiltration of skin.

Dr Iskander Chaudhry

 

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