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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 2884 - 27 July 2021 Posted By: Iskander H. Chaudhry

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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51 Female, persistent rash on right upper arm.


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Meenakshi Batrani

Posted

There is predominance of CD4 cells, subtle epidermotropism more evident on IHC and papillary dermal fibrosis. Suspicious for mycosis fungoides, however a distinction from T-cell pseuodolymphoma or MF mimic requires clinical correlation and additional IHC such as loss of CD2, 5, 7. There also appears to be interstitial mucin deposition which has been described in some variants of MF. 

 

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Krishnakumar subramanian

Posted

lupus tumidus, as there is perieccrine inflammation and there is mucin in dermis

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Krishnakumar subramanian

Posted

can we have CD123 that will support lupus tumidus, as it can mimic Cutaneous Marginal Zone B-cell Lymphoma/T cell lymphoma

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vincenzo

Posted

?Sezary/MF

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Eman El-Nabarawy

Posted

Clinical correlation is mandatory. Favor lymphomatoid drug reaction.

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vincenzo

Posted

The intraepidermal cells are many times larger than the dermal ones. 

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Admin_Dermpath

Posted

Dr Chaudhry's response: 

Clinically the case was highly suggestive of MF. 

The case was reported as skin with mild acanthosis and a moderate lymphoid infiltrate in the papillary dermis with epidermotropism and rare atypical lymphoid cells expressing CD4. 

The features raise the possibility of early mycosis fungoides. Correlation with the clinical and cytogenetics are advised.

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HENRY

Posted

did not see convincing evidence of MF. but it may be an evolving one. have to rule out other mimickers such as lymphomatoid drug reaction

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