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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 2680 - 14 October 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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46 year old female with biopsy of rash from thigh. (Courtesy of Dr Sarah Al-Awami.)


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Mastocytosis-TMEP?

There is fibrosis in papillary dermis. 

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Richard Logan

Posted

I would exclude fungus with a PAS stain, but I think the most likely diagnosis is erythema annulare centrifugum.

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Saman Fatah

Posted

Probable pityriasiform spongiosis pattern with a few conditions exhibiting such microscopic appearance as listed by Weedon including EAC as suggested by Richard.

I am uncertain about the exact nature of infiltrate within dermis, some looks like mast cells and others possibly lymphoid with variable nuclear contours. Clinical correlation is essential and if above diagnoses were unlikely, then an early stage CTCL may be down the bottom of list in the differential diagnoses.

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Krishnakumar subramanian

Posted

i will call it spongiotic dermatitis , get a PAs stain done to rule out dermatophytosis

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figurate erythema versus pityriasis rosea.I favor the latter.

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On 17/10/2020 at 11:19, dermpath1 said:

figurate erythema versus pityriasis rosea.I favor the latter.

Quote

Agree.

 

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Dr. Hafeez Diwan

Posted

I went with EAC. Fungal stain was negative.  Pityriasis rosea was in the differential. Clinically, it was considered to be EAC.

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