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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 3089 - 05 May 2022 Posted By: Saleem Taibjee

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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51F diagnostic biopsy right knee ?psoriasis


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Anil Patki

Posted

Parakeratosis, scale-crust and interstitial infiltrate of histiocytes with some floating collagen are suggestive of interstitial granulomatous dermatitis.

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Meenakshi Batrani

Posted

Agree with interstitial granulomatous dermatitis. 

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Eman El-Nabarawy

Posted

 Interstitial granulomatous dermatitis.

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vincenzo

Posted

Not Kaposi, but now thinking of dermatomyofibroma

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Saleem Taibjee

Posted

This was a bit of an odd recent case. But a reminder to consider the possibility of more than one pathology on the slide....

The PAS stain is shown below, highlighting fungal hyphae within the stratum corneum, and thus indicating tinea. I suspect that this is what the clinician was seeing, hence the suggestion of psoriasis on the clinical request form.

It is a bit of a pale section originating from another laboratory which adds to the challenge. I suspect that the dermal proliferation is 'incidental', and I believe consistent with additional dermatofibroma. It is clearly storiform centrally with the typical rounding up of collagen bundles entrapped at the peripheries but not centrally, hence I don't think it is an interstitial granulomatous dermatitis, but I can certainly see why some of you have considered that.

BW, Saleem

48874_40.0x PAS labelled.jpg

48874_51.4x PAS labelled.jpg

48874_20.0xe.jpg

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