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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2175 - 10 October 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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78 year-old female with bullae.
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Go to records October 2018

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Anil Patki

Subepidermal clevage with lots of eosinophils.  Cell-rich type of bullous pemphigoid. 

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anh

Basically agree with Anil. The unusual features of this bullous disease are the pseudoepitheliomatous hyperplasia and dermal fibrosis or scar (vertically oriented blood vessels in the dermis). So I would like to add cicatricial pemphigoid in the differential diagnosis.

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vincenzo

vincenzo 4

Posted (edited)

Yes. There are eccrine ducts, so this is skin; but CP ( aka MMP ) can hit skin also.

Edited by vincenzo

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Dr. Hafeez Diwan

Dr. Hafeez Diwan 125

Posted

There is no mucosal membrane involvement.  Clinically this was BP.  Given the scarring/pseudoepitheliomatous hyperplasia, I called this pemphigoid nodularis (BP).

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

Nice case! Don't think I've seen this variant in practice.

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