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 2344 - 11 June 2019 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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75 year old female with erythroderma of unknown duration


User Feedback


Alex-Ventura-Leon

Posted

Yes, first thought MF.

ATLL is another possibility (If the patient is HTLV1 positive of course) 

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Anil Patki

Posted

Epidermotropism, Pautrier

microabscesses and possibly empty underbelly sign. MF! 

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Erythrodermic mycosis fungoides.  If circulating sezary-cells—>SS. 

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This patient could have erythrodermic MF (classical clinical history of MF progression should help to diagnosis), Sézary (if laboratory findings correlate with it) or an Erythrodermic PCTCL, if both the above diagnosis are not confirmed. We can not forget the possibility of pseudolymphomatous T-cell drug reaction, so it is important to see the medications this patient is using.

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Krishnakumar subramanian

Posted

epidermotropic lymphocytes

IHC is needed to know and clinical information on any drug which can being this

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Uma Sundram

Posted

Great comments. The things to ask the clinician about include: 1) duration of erythroderma 2) presence of alopecia, ectropion, acral keratoderma 3) lymph adenopathy 4) circulating Sézary  cells with abnormal immunophenotype. The patient has had erythroderma for more than a year, alopecia and palmoplantar keratoderma, lymphadenopathy, and abnormal circulating cells with Sézary  morphology and CD7-CD26- phenotype. No pre existing patches and plaques of MF. The combined clinical and pathologic findings qualify for the diagnosis of Sézary  syndrome.

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