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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 2547 - 10 April 2020 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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M55. Keratotic itchy papules since childhood, on arms, legs, abdo & feet. ? keratosis pilaris – severe. Other keratotic disorder of genetic origin.


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Keratosis lichenoides chronica , Nekam’s disease?

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Mohamed khaled

Posted (edited)

Agree with lichen nitidus for clinicopathological correlation.

Increased the vasculature at the papillary gave me the impression of APACHE. But still being very focal and the clinical picture are in favour of lichen nitidus.

Edited by Mohamed khaled

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Claw and ball pattern of inflammatory infiltrate and epidermal acanthuses, with atrophic overlying epidermis...agree with Cem: Lichen Nitidus.

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Saman Fatah

Posted

The pattern of changes consists with lichen nitidus histologically but the clinical features are keratotic papules of childhood onset. Would add PRP with lichen nitidus-like histology features as a differential diagnosis that requires clinical correlations as latter is rare. 

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Dr. Richard Carr

Posted

Good suggestions. We also considered lichen nitidus but felt the features were more in keeping with Flegel's (hyperkeratosis lenticularis perstans).

I'd like to thank Dr Domenico Mesiano for sharing this case.

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