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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 2335 - 29 May 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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50 year-old HIV positive male with failure to thrive for 3 months. He has a diffuse desquamating rash and edema


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IgorSC

Posted

I see an ulcerated skin lesion and in the last 2 pictures there are some large oportunistic organisms that looks like acanthamoeba. So this should be a case of acanthamoebia cutis.

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Krishnakumar subramanian

Posted

parakeratosis with hypogranulosis. some inflammatory cells in parakeratosis. there is vacuolar changes in basal cell layer

? drug rash

any PAS stain available

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I also think the last 2 pictures show some kind of microorganisms. There is a hair follicle below so I would do deeper level sections to see whether the hair follicle is involved. Maybe just molluscum contagiosum.

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Anil Patki

Posted

Mound of parakeratosis about the follicular opening suggests seborrhoeic dermatitis in the setting of HIV infection. Clinical correlation needed. 

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Saman Fatah

Posted

I thought about the possibility of nutritional deficiency dermatoses group (Zinc/acrodermatitis/NME and others) but obviously clinical correlation is essential.

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Dr. Hafeez Diwan

Posted

The patient had extremely low protein/albumin levels.  Clinically this was felt to be kwashiorkor and histologically it fits with that.

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Dr. Mona Abdel-Halim

Posted

Great case, I was thinking nutritional deficiency too

 

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