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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 2517 - 28 February 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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F55. Blistering R foot. DD: ? Pompholyx/eczema ??Pemphigoid


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Krishnakumar subramanian

Posted

spongiotic sub corneal blister with mixed inflammatory cells

could be pompholyx or id reaction to fungus

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Typical flask shaped bulla. Favor pompholyx. 

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Dr. Mona Abdel-Halim

Posted

Herpes, I think we r having viral cytopathic changes in image 4.

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Dr. Mona Abdel-Halim

Posted

Nice! Thought of vesicular tinea pedis initially but the acantholytic cells in image 4 made me think viral.. first thoughts are always right!!

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Yes! Always do the PAS when you are in front of a spongiotic dermatitis with neutrophils. Nice case.

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Saleem Taibjee

Posted

From a clinical point of view, always consider tinea if unilateral. Pompholyx (hands/feet) can also be an id reaction to tinea pedis.

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Dr. Richard Carr

Posted

Yes this is tinea pedis with a pompholyx pattern. Thanks for discussion. Beware of IMF as there are case reports of positive basement antibodies in bullous tinea that could lead to an inappropriate treatment. 

image.thumb.png.938181afece16ca3cc7d94bb704472f7.png

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