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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 2237 - 9 January 2019 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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Biopsy from 61 year-old male with a skin rash. (Courtesy of Dr. Amada Moyer.)


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Anil Patki

Posted

Parakeratosis and erythrocytes in the epidermis suggest pityriasis lichenoides chronica. 

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Alex-Ventura-Leon

Posted

Difficult (for me). But i see some intraepidermal lymphocytes with mild "atypia" and that make me think in Pityriasis Lichenoide.

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PRP or Pityriasis Rosea? In fig 3 there is a checkerboard pattern of orto and parakeratosis, as espected in PRP...and extravasated erythrocytes, as expected in PR of Gilbert. CPC is mandatory!!!

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Dr. Hafeez Diwan

Posted

Pityriasis rubra pilaris.  It was the clinical impression as well.

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Dr. Richard Carr

Posted (edited)

Agree with Vincenzo. I too considered P. rosea. I'm sure I read in Weedon once PRP is the diagnosis he missed most!  I guess in my experience having the clinician suggest it helps but Weedon's comment always made me think of the diagnosis so I hope I've not missed too many. Best to learn from other's "mistakes". I don't think Weedon missed much though!

Edited by Dr. Richard Carr
!

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