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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 3008 - 17 January 2022 Posted By: Dr. Mona Abdel-Halim

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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M 45,Unilateral firm erythematous nodules and plaques affecting the right forehead and right eye-brow with loss of hair from the eye-brow of gradual onset and progressive course of 1-year duration


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IgorSC

Posted

Fungal infection, probably by dermatophyte.

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Richard Logan

Posted

Yes.  Given the deep and granulomatous nature of the reaction I guess Majocchi's granuloma would be a reasonable term to use here.

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vincenzo

Posted

Granulomatous dermatitis, maybe Candida. 

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Anil Patki

Posted

Tissue invasion by non pigmented,  septate hyphae and the chronic granulomatous infiltrate suggest a deep fungal infection of hyalohyphomycosis type. The identification of the causative fungus will need culture and help of a microbiologist. 

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Krishnakumar subramanian

Posted

Underlying CARD9 mutation needs to be ruled out because of the invasive fungal infections

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Dr. Mona Abdel-Halim

Posted

On 20/01/2022 at 08:59, Krishnakumar subramanian said:

Underlying CARD9 mutation needs to be ruled out because of the invasive fungal infections

Yes, this was a case of deep dermatophytosis

Repeated cultures revealed Epidermophyton floccosum

 

We think the patient has CARD9 mutation, still trying to see if testing for it is available in Egypt or not

Thank you all!

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