FAADV 2012.1.1 EAC or LE (diagnostic pitfall in the superficial and deep infiltrate)
Thu, 01/19/2012 - 00:03 — Dr. Yu-Hung Wu M.D.
A 27 year old woman has asymptomatic rash occurring gradually on her chin and upper arm. There is no good response to topical therapy prescribed by family physicians.
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Comments
first case
1. clinical differential diagnosis :
a. cutaneous lupus - SCLE, lupus tumidus
b. tinea facialis
c. annular erythema
d. leprosy
2. inflammatory pattern - superficial and deep perivascular infiltrates ("patchy infiltrates")
others epidermis unremarkable from low power/scanning view
infiltrates are mononuclear ( lymphoplasmacytic with some histiocytes)
3. Differential diagnosis
a. Lupus tumidus
b. annular erythema
PAS stain maybe useful to exclude tinea.