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Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Dec 17, 2012.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    What is your medical diagnosis ?

    Dermatology Case.jpg
     

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  2. neo_star

    neo_star Moderator

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    Keloid secondary to ear piercing.
     

  3. Xerxles

    Xerxles Well-Known Member

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    Isnt a Keloid supposed to be a scar,, how would you explain the smooth skin surface, and the marked redness seen in
    this photo...
    [/SIZE]
     

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  4. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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  5. neo_star

    neo_star Moderator

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    Good u raised this doubt, thanks (-:

    First let me answer whether this could qualify as a keloid ?

    Well, if i biposy it and see - type 3 collagen with exuberant granulation tissue, i will not shy away from calling it a keloid.

    Now can it look like the way it does in this image ?

    Yes, this is a very small trauma and the scar tissue will just end up growing into the surrounding skin and can look like this.

    Is there another possibility / differential diagnosis ?

    yes

    suppose the biopsy report said - cornified epithelium containing lamellated keratin, then i would call it an epidermoid cyst ( aka epidermal cyst, epidermal inclusion cyst, infundibular cyst and keratin cyst ).

    The mechanism in this case is migration of epidermis into dermis.

    [​IMG] this is a confirmed epidermal inclusion cyst, again from ear piercing.

    So was I smart in identifying the image in this challenge as keloid ?

    Absolutely NOT !!!

    Thanks again, becos if it was not 4 ur doubt, i wouldn't have given it a thought.

    So first differential - keloid ( no particular reason 4 putting it as the first differential )
    Second differential - epidermal inclusion cyst

    (Y)
     

  6. danielmx

    danielmx Active member

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    in fact that is the classic picture of a keloid. it's not like you could even doubt it, a trauam from earing perforation can easily do that. Xerxles was kind of rough =/.
     

  7. dr.angela

    dr.angela Bronze Member

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  8. Rocket Queen

    Rocket Queen Super Moderator

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  9. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Answer : Keloid
     

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