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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 2445 - 15 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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M80. Erythematous patches. Left forearm, Lt hand. ?Granuloma, ?infection fungal, ?contact dermatitis, ?others

Edited by Admin_Dermpath


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Suppurative granuloma caused by fungus with broad-based budding yeasts. ? Blastomycosis or other fungus. Culture is required for identification

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On 15/11/2019 at 10:53, vincenzo said:

Sporotrichosis.

Yes, agree with Vicenzo. Sporothrix schenckii are usually seen inside supurative granulomas and are difficult to see. Great!

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Dr. Richard Carr

Posted

I don't recall ever seeing sporotrichosis in the UK but of course it could be imported. The case was a recent one from St Elsewhere and I don't have culture results. I suspected an early eumycetoma might be more likely as I thought some of the structures were quite elongated. Obviously culture or PCR would provide the final answer.

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Dr. Richard Carr

Posted

I'm adding a new images on additional Grocott stained sections we can see yeasts & hyphae growing in a hair shaft so this is a Majochi's granuloma. This actually makes a lot more sense in the UK than sporotrichosis or blastomycosis.

 

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