Case Number : Case 2787- 12 March 2021 Posted By: Richard Logan

??Scabies. 

Intradermal nevus

Eosinophilic spongiosis? Cause

Hypersensitivity reaction pattern (Insect bite?, scabies? drug?)

Esinophilic spongiosis for D.D

While this pattern of changes is not specific for a particular diagnosis, this is a biopsy from a young female and on abdomen hence one would consider Polymophic Eruption of Pregnancy (PEP) or PUPPP if the lady is pregnant especially primigravida. 

Usually such cases diagnosed clinically in the right context and if biopsy done perhaps a prebullous stage of pemphigoid gestationis was in the clinical differential and IMF needed to exclude or confirm the latter. 

8 hours ago, Saman Fatah said:

While this pattern of changes is not specific for a particular diagnosis, this is a biopsy from a young female and on abdomen hence one would consider Polymophic Eruption of Pregnancy (PEP) or PUPPP if the lady is pregnant especially primigravida. 

Usually such cases diagnosed clinically in the right context and if biopsy done perhaps a prebullous stage of pemphigoid gestationis was in the clinical differential and IMF needed to exclude or confirm the latter. 

Well done Saman - this was a case of polymorphic eruption of pregnancy.  I deliberately withheld the crucial information that she was pregnant.  As you say most of these cases are diagnosed clinically without the need for a biopsy.

There is an eosinophil-rich dermal infiltrate with mild spongiosis.  The images shown don't really allow for a close inspection of the epidermal cytology, but there weren't any eosinophils in the epidermis, so strictly speaking these slides do not demonstrate eosinophilic spongiosis.