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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 4364 - 12 October 2023 Posted By: Shashi Baksh

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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66 year old woman with a few discrete erythematous maculopapular lesions, some with crust on lower extremities and hips. No associated systemic symptoms. Had similar eruption on upper extremities two years ago.


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smbaksh@psppath.com

Posted

Type D Lymphomatoid papulosis was one of the main differential considerations.

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Type B LP could fit well clinical history and IHC features ( CD4+, CD7, CD3 loss ). 

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smbaksh@psppath.com

Posted

This was an interesting case of PLEVA (intraepidermal lymphocytes are predominantly CD8-positive) with a clonal T-cell rearrangement.  A concurrent biopsy from another site showed early changes of PLEVA with no loss of CD7.  The biopsy two years ago was histologically similar to the current lesion with foci of epidermal necrosis but with no loss of CD7. 

CD30 showed only rare positive cells, and CD56 was negative.

The patient was referred to cutaneous oncology for F/U.

 

 

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