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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 2674 - 06 October 2020 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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25 year old female with full body rash and perioral lesions.


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Richard Logan

Posted

A sub-epidermal blistering disorder which in these slides is centred around a hair follicle.  There is a vacuolar interface dermatitis, apoptotic cells at all levels of the epidermis and a certain amount of pigmentary incontinence.  I think the diagnosis rests between erythema multiforme major (Stevens-Johnson syndrome) or acute graft versus host disease.  Clinico-pathological correlation needed.

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Saman Fatah

Posted

Florid vacuolar interface dermatitis with pan-epidermal apoptosis and basket wave stratum corneum. 
Beside the above listed common causes of this pattern of reaction, I would add one more but uncommon possibility as she is a young female, TEN-like presentation of lupus erythematous. 
If full body rash meant epidermal detachment then it means >30% BSA involvement which pushes the clinical diagnosis to TEN end of the spectrum. 

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Anil Patki

Posted

Full thickness epidermal necrosis and dermal silence point towards toxic epidermal necrolysis.

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Uma Sundram

Posted

SJS-TEN. Patient was recently on sulfoamides. Has targetoid lesions as well w rapid onset of desquamative rash.

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