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?

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Case Number : Case 2435 - 1 November 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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F65. Right medial forearm. ?twin dermatofibromas. c/o Dr Neil Catterall

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Krishnakumar subramanian

Posted

severe elastic degeneration seen, with myxoid lesion, the  image is slightly out of focus sir, can we have better images

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Dr. Richard Carr

Posted

Sorry not sure I can see any problem with the focus.

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Krishnakumar subramanian

Posted

image 2 showing lot of  cracks in the deposits

could be colloid milium with severe  actinic damage

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Dr. Richard Carr

Posted

Yes well done: Raimer's (solar elastotic) bands of the forearm. Thanks to Neil Catterall for bringing this case.

Acta Derm Venereol. 1995 Sep;75(5):372-4.
Raimer's bands: case report with a review of solar elastosis.
Stanford DG1, Georgouras KE, Killingsworth M.
Author information
Abstract
Raimer's solar elastotic bands of the forearm are a rarely described clinical variant of severe solar elastosis. We report a case of Raimer's bands on the forearm of a 43-year-old woman. Light microscopy demonstrated solar elastosis and electron microscopy revealed activated fibroblasts appearing to secrete the elastotic material. The clinical variants of solar elastosis are outlined and the possible pathogenesis of the elastotic material is discussed.

J Am Acad Dermatol. 1986 Oct;15(4 Pt 1):650-6.
Solar elastotic bands of the forearm: an unusual clinical presentation of actinic elastosis.
Raimer SS, Sanchez RL, Hubler WR Jr, Dodson RF.
Abstract
Actinic damage of dermal tissues produces several distinct clinical patterns. Three patients are described as having discrete, soft, cordlike bands on the forearms that extend from dorsal areas of actinic damage and senile purpura to greatest prominence in flexural regions with less solar damage. Histochemical analyses and light and electron microscopy studies of the plaques showed changes consistent with solar elastosis. The clinical variants of actinic elastosis and the possible origins of the abnormal elastic fibrils found in the dermis of chronically sun-damaged skin are discussed. Solar elastotic bands are an unusual form of actinic degeneration.

 

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