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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 2345 - 12 June 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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37 year-old female with biopsy of crown

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User Feedback

Perifollicular emorragia, distorted hair follicles, and pigment casts are in keeping with Trichotillomania alopecia. Unfortunately I am not sure about the not scarring nature of this lesion...but agree with Colleagues.

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John Zhang


Pigment casts can be seen in both trichotillomania and alopecia areata. The lack of telogen/catagen increase, makes me favor trichotillomania or post operative alopecia, although the top right of fig seem to have peribulbar inflammation.

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