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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 2535 - 25 March 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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50 year-old female with biopsy from left ankle.


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An angiomatous growth in a actinic skin, with elastic damage, could lead to thinking of an acquired elastic hemangioma, but this lesion show vascular channels not horizontally oriented, and with fibrinous microtrombosis. There is erythrocytic extravasation, also. So favor a stasis dermatitis, interviewing in a actinic skin.

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Dr. Mona Abdel-Halim

Posted

Or lividoid vasculopathy? 

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Victor Delgado

Posted

There is epidermal atrophy with mild atypia, probably due to dermal changes, where we can see extravasated RBCs, vascular congestion, width vascular walls, fibrinoid material on them and a few thrombus. Agree with Mona, I would prefer to call this Livedoid Vasculopathy.

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Yes, Mona. I was off road. Livedoid Vasculopathy is the right diagnosis. 

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dermpath1

Posted

There is a mucin in the dermis.Better to exclude lupus.

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I would suggest stasis, as it is ankle; epidermis is hyperkeratotic; there is lobular small vessel hyperplasia with fibrin thrombi, probably focal fibrinoid necrosis and extravasation of erytrocytes. There are neutrofiles within stratum corneum, and I would do PAS. There is severe solar damage. But I wonder, if something even more important is hiding.

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Dr. Hafeez Diwan

Posted

Atrophie blanche/livedoid vasculopathy.  There is a background of stasis.

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Dr. Richard Carr

Posted

Agree with stasis - severe. Needs CPC of course.

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