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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 2369 - 19 July 2019 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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M75. Eyebrow. Few weeks, painful lesion

Edited by Admin_Dermpath


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Krishnakumar subramanian

Posted

painful lesion with necrosis with involvement of the follicle and mixed inflammation

Suspicious  MNGC seen in image 4. Herpetic folliculitis

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Nuclear molding, multinucleation, chromatin clumping, all characteristics of Herpes virus infection.

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1 hour ago, IgorSC said:

Nuclear molding, multinucleation, chromatin clumping, all characteristics of Herpes virus infection.

Totally agree!

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Anil Patki

Posted

History of few weeks makes me wonder whether it's staphylococcal folliculitis

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Dr. Richard Carr

Posted

Great responses.

Yes this is either varicella zoster or herpes folliculitis (HSV1 > HSV2). Most cases with predominantly follicular involvement a here (as opposed to accompanying surface) relate to VZV). The necrotic sebaceous units are a big clue and I agree there are subtle multinuclear cells with viral cytopathic changes.

https://www.ncbi.nlm.nih.gov/pubmed/16536821

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