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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 2555 - 22 April 2020 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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41 year-old male with biopsy from left lower back. He was recently diagnosed with CLL.


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Spongiotic dermatitis with last week sign.

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Meenakshi Batrani

Posted

Elongated mounds of parakeratosis with mild perivascular lymphocytic infiltrate. ?Could be erythema annulare centrifugum which can occur in the setting of CLL.  No eosinophils to consider eosinophilic dermatosis of hematological malignancy. 

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Dr. Mona Abdel-Halim

Posted

On 22/04/2020 at 17:01, vincenzo said:

PAS?

Yes, any stains done?

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Dr. Hafeez Diwan

Posted

PAS was negative.  I called it resolving spongiotic dermatitis. It has the "last week" sign.

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Krishnakumar subramanian

Posted

• Finally, you relax in the weekend and think about what you have achieved last week, you remember (The Last Week Sign) when you see parakeratosis overlying basket weave orthokeratin indicating a no longer active dermatosis, a dermatosis that is playing itself out.Thanks Dr

 

 

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Very interesting, thanks to Dr Hafeez and Dr Mona!

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