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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 2764 - 9 February 2021 Posted By: Uma Sundram

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

65 year old female with multiple medical problems, now with full body desquamative rash; oral mucosa
is involved.


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Alex-Ventura-Leon

Posted

Stevens Johnson Syndrome

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Carmen Lisievici

Posted

Agree with Stevens Johnson syndrome.

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Richard Logan

Posted

2 hours ago, Meenakshi Batrani said:

SJS or TEN

I think I would go for TEN in view of the description of "full body desquamative rash".

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Dr. Richard Carr

Posted

Pigment incontinence suggests it's a little longer standing than is typical for EM / SJS. I note some colloid bodies in clusters and a hint of acantholysis. How about paraneoplastic pemphigus in addition to the suggestions above.

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vincenzo

Posted

2 hours ago, Dr. Richard Carr said:

Pigment incontinence suggests it's a little longer standing than is typical for EM / SJS. I note some colloid bodies in clusters and a hint of acantholysis. How about paraneoplastic pemphigus in addition to the suggestions above.

There is a predominantly acantholytic pattern of injury, with eccrine duct involvement resembling post chemotherapeutic changes. Also there is pigment incontinence, as R.C. said. I’m not familiar with Paraneoplastic Pemphigus, but I’ll take this diagnosis over EM/SJS/TEN. 

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Saman Fatah

Posted

Well spotted and explained by Dr Carr. Favour pemphigus as well and further information is needed such as DIF/transitional epithelium immunofluorescence results to clarify if PNP or not. 

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Uma Sundram

Posted

It's early yet, but both Pemphigus and SJS/TEN were suggested. Waiting for additional biopsies for r/o Pemphigus.

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Richard Logan

Posted

On 11/02/2021 at 21:14, Uma Sundram said:

It's early yet, but both Pemphigus and SJS/TEN were suggested. Waiting for additional biopsies for r/o Pemphigus.

Can you let us know the outcome of further biopsies please?

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Uma Sundram

Posted

We don't have any further follow up. I believe the patient was transferred to another hospital but no other biopsies came our way.

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