Case Number : Case 2517 - 28 February 2020 Posted By: Dr. Richard Carr

spongiotic sub corneal blister with mixed inflammatory cells

could be pompholyx or id reaction to fungus

Typical flask shaped bulla. Favor pompholyx. 

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

Pompholix 

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

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

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

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.