Jump to content
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 2847- 04 June 2021 Posted By: Dr. Richard Carr

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

F40. Rash


  • Like 1
  Report Record

User Feedback


vincenzo

Posted

Difficult for me. ? Neutrophilic eccrine hidradenitis, ?purpuric dermatosis ( but there are too pmn in dermal infiltrate ). Waiting for answer. 

Share this comment


Link to comment
Share on other sites

Krishnakumar subramanian

Posted

some dermal perivascular eosinophils with basal cell vacuolar changes

? drug rash

 

Share this comment


Link to comment
Share on other sites

Dr. Richard Carr

Posted

The pattern is a subtle neutrophilic dermatosis with neutrophilic epitheliotropism (eccrine duct) = neutrophilic urticarial dermatosis. We can see a few colloid bodies but no eosinophils in these images. 

Can be a clue to many conditions but in this case I believe it was is adult onset Still's disease. Great references as follows....

https://pubmed.ncbi.nlm.nih.gov/26317390/

https://pubmed.ncbi.nlm.nih.gov/30224079/

 

Share this comment


Link to comment
Share on other sites

Krishnakumar subramanian

Posted

sir, we can get neutrophils in acrosyringial ducts in  miliaria pustulosa too, how to exclude that and go for this rare diagnosis sir

Share this comment


Link to comment
Share on other sites

Richard Logan

Posted

Miliaria would be a highly unlikely diagnosis at this age.

Share this comment


Link to comment
Share on other sites

Krishnakumar subramanian

Posted

understand sir, i read the 2 articles suggested by Dr Carr. It was wonderful. Just to trigger Dr Carr.. He could have suggested  a clue as urticarial rash

Share this comment


Link to comment
Share on other sites

Dr. Richard Carr

Posted

49 minutes ago, Krishnakumar subramanian said:

understand sir, i read the 2 articles suggested by Dr Carr. It was wonderful. Just to trigger Dr Carr.. He could have suggested  a clue as urticarial rash

Yes I could have been more helpful but for dermpathpro I expect more! and you usually deliver! I hope you won't now forget the pattern even though I was mean to you.

Share this comment


Link to comment
Share on other sites

Krishnakumar subramanian

Posted

Thanks sir, shall improve

Share this comment


Link to comment
Share on other sites



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...