A 60 yr diabetic female, presented with such lesions.The lesions are on and off for past 2 years, they appear at the same site (right upper thigh)and resolve completely on their own with hyperpigmentation. They occur again after few days or weeks at the same site. associated with burning sensation, no itching. Kindly opine on the DDs

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Dr. Saumya, Good case and good presentation of case. In my impression is History of recurrence of lesions on same site with burning and no itching, Erythematic borders with deep perivasularity and arcuate shaped lesions in diabetic , KOH mount is negative, more appropriate DD s are ERYTHEMA ANNULARE CENTRIFUGAM, ERYTHEMA GYRATUM REPENS LUPUS ERYTHEMATOSUS POROKERATOSIS NEUTROPHILIC FIGURATE ERYTHEMA

Thank you sir for your valuable opinion Will surely add these to the DDS Histopathology sent W8ng fr da reports

Dr Sowmya, thanks for remembering. Central depressed atrophic area bounded by keratotic border looks like - 'porokeratosis'. But then the history is unusual very few cases of " recurrent porokeratosi with spontaneous resolution " are reported in literature. Additional interesting point in this case is " recurrence at the same site. So pl take biopsy of fully evolved ( marked SS) and lesions in evolution and seek a dermopaths impression. If histologically proved, it may be a good case for publication. Hope u will make me a patner if all goes well. It is possible that it could be otherwise. Let us see what ohers have to say. Don't try to treat it till biosy. If possible mail me the post@ drasv@ymail.com. Give what u feel also. Criticism welcome.

Sir we hv kept one differential as porokeratosis Nd hv already sent Histopathology W8ng fr da reports

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Allergic contact dermatitis

Herpetic lesion or giant urticaria ass with neutrophilic def syndrome

Allergic contact dermatitis

But there is no itching sir

Necrobiosis lipoidica should also be s Ddx. Is patient on insuline?

Kept NLD also as differential Pt is on OHAS nt insulin W8ng fr histopath

The lesion is indurated and non itchy,, she nvr had itching KOH mount is negative ruling out the possibility of tinea Kindly opine on DDs apart from tinea



Tenia incognito

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