Case Number : Case 2427- 18 October 2019 Posted By: Dr. Richard Carr

dermatophytosis

Nice case. PAS is a very useful stain in Dermatopathology.

Agree but whats that catch! Is there associated keratoderma and Sezary syndrome? 

There's abrupt decrease in the thickness of stratum corneum. I think there is associated circumscribed palmar hypokeratosis. 

The H&E were intended to be posted separately (not with the PAS).

Anil - I suggested in my provisional report (it was an outside case from a "backlogs" company) appearances are suggestive of focal acral hypokeratosis and I was quite pleased with myself but in view of location (PAS to follow). The PAS was a surprise. Not sure if it's dual pathology or just a mimic but agree it is most definitely tinea manuum. Sadly no Sezary as well! Although I remember well a case that Heinz Kutzner shows in his wonderful lecture on infections disease of tinea nigra with a subtle accompanying lentigo maligna!!!!!

Incidently a small anecdote. While giving his [Kutzner] lecture I touch typed his words into a powerpoint of my own notes. When Heinz Kutzner sat down after one of the best lectures I'd ever had the pleasure to witness he looked at me quizically. I said :"I hope you don't mind I just typed out your talk".  He had never met me before and did not know I was a speaker too. He handed me his memory stick and said "take it". I was almost speechless, the culture elsewhere and particularly in London was always very "protective" over one's lectures (although Eduardo Calonje and I always shared talks we'd done with great pleasure). Anyway I somehow blurted out "thank you I'll only use it for local teaching" to which he said "you can publish on the internet if you want". Well if that is not a great human I don't know what is. Since then I have always tried to be open and share whenever I can. It's always tremendously dissappointing when one gets a negative reaction to request like "Do you mind if I take a copy of your talks for local teaching". I remember one organiser of a meeting who shall remain nameless when he overhead me make the request (to a close friend in dermatopathology) who was far from impressed.. Fortunately the friend, also a great speaker who has made a massive contribution in dermatopathology, kindly said "no it's okay Richard and I always share our talks." Incidently Kutzner invited me and Saleem Taibjee to visit his lab in Friedrichschafen, and we did go, and I will say it was a wonderful and career changing experience .