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Virtual Case of the Month
Rare necrotic lesion in a pregnant woman
  1. James Wiggins1,
  2. Emily Hayes1,
  3. Marc Heymann2,
  4. Rand Hawari3,
  5. Richard A Carr1
  1. 1 Department of Histopathology, South Warwickshire NHS Foundation Trust, Warwick, UK
  2. 2 Respiratory Medicine, Queen’s Hospital, Romford, UK
  3. 3 Department of Histopathology, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
  1. Correspondence to Dr Richard A Carr, Warwick Hospital, Department of Histopathology, Warwick CV34 5BW, UK; Richard.Carr{at}swft.nhs.uk

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Clinical question

A 34-year-old female community nurse in her first trimester of pregnancy presented with a 2-week history of a tender, swollen and hyperkeratotic lesion on her chest with no history of trauma. The lesion started as a red ‘spot’, became crusted, pustular and formed an eschar. A generous incisional biopsy was taken.

Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2017-204459 and consider your diagnosis.

What is your diagnosis?

  1. Anthrax

  2. Cowpox

  3. Orf

  4. Pseudocowpox (Milker’s nodule)

  5. Varicella zoster

 The correct answer is after the discussion.

Discussion

Histopathology shows superficial ulceration, …

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