Male 34 years

Known psoriasis patient with history of flares, admitted into the intensive care unit with bacterial sepsis and a generalised rash affecting nearly the entire body surface area, which erupted a day after intake of amoxicillin for tooth extraction. Also has AKI on CKD and transaminitis. Rash not responding to aggressive intravenous antibiotics and fluids. ?septic vasculitis ?drug reaction. Skin punch left posterior arm.

Male 60 years

COVID 19 positive, suffered cardiac arrest, hypoxic brain injury, seizures and myoclonus following surgery for perforated duodenal ulcer. He was placed on antiepileptic drugs (levetiracetam, sodium valproate and clonazepam) after which he developed widespread erythema and denuded skin affecting 60% body surface area. Transferred to the burns unit. Skin punch left shin.

Female 73 years

Known hypertensive and diabetic on treatment, previous history of TIA, admitted on account of generalised pruritus and progressively worsening widespread bullous rashes. No mucosal involvement. ?drug eruption. Skin punch left posterior shoulder.

Male 1 years

Seizure disorder on anti-epileptics, developed a blistering maculopapular rash that recurs on the same areas of the left thigh and upper back after taking carbamazepine. ?fixed drug eruption. Skin punch left thigh.

Male 61 years

Known diabetic and bipolar disorder, admitted into the ICU with bilateral large cerebral infarcts preceded by a 4-week history of a non-blanching itchy rash over the lower legs, hands and back. Also had diarrhoea with fresh blood and joint swelling. ?sepsis. Skin punch right hip.

Female 38 years

History of SLE and antiphospholipid syndrome, admitted into the ICU with type 2 respiratory failure secondary to community acquired pneumonia complicated by sepsis. She was placed on Tamiflu and Tazocin, developed a pustular rash spreading from her left leg to her abdomen and submammary area. ?Acute generalised exanthematous pustulosis (AGEP), ?pustular psoriasis. Skin punch left thigh.

Female 34 years

COVID 19 positive, history of c-ANCA positive Wegener's granuiomatosis on prednisolone and rituximab, admitted into the intensive care unit for bacterial sepsis while being worked up for rhinoplasty. She was placed on intravenous flucloxacillin, developed painful skin lesions on the legs, arms and groin. ?vasculitis ?infection. Microbiological findings on tissue biopsy negative. Skin punch right forearm.

Male 70 years

Known hypertensive with bilateral leg lymphoedema, admitted with left lower leg and foot cellulitis which resolved on treatment with intravenous antibiotics. He developed, a week later, a painful erythematous pseudovesicular violaceous nodule on the dorsum of the right hand. ?vasculitis ?cellulitis ?xanthomatosis ?sarcoid. Skin punch right hand.

Male 57 years

On adjuvant capecitabine chemotherapy for colonic adenocarcinoma, admitted with neutropenic sepsis, mucositis, widespread rash and AKI. ?erythema multiforme ?Steven Johnson syndrome. Skin punch right lateral neck.

Male 82 years

Pruritic rash on the upper back. Punch biopsy revealed spongiotic dermatitis and skin scrapings showed the presence of fungi. He was placed on itraconazole and topical corticosteroids. The rash however worsened and disseminated (suberythrodermic). ?mycosis fungoides, ?eczema ?psoriasis ?tinea incognito. Skin punch left thigh.

Male 72 years

Excision of pigmented lesion vertex of the scalp. Melan A and SOX 10 positive, Ki 67 index <1%.

Male 85 years

Excision of BCC, right zygomatic region. Spindled areas show strong and diffuse positivity for vimentin and SMA, patchy positivity for AE1/3, negativity for desmin, caldesmon, myogenin, 5100 and p40.

Male 77 years

Sebaceous cyst left axilla.

Male 82 years

Excision of skin lesion upper back; psitive for BerEP4, negative for CK7, CK20, CEA, p63, CD117, 5100, TTF1, GATA3, synaptophysin.

Female 57 years

Fleshy vascular tumour in left nasal vestibule; positive for AE1/3, CAM5.2, chromogranin, synaptophysin, CD56, CK20 (dot like positivity); negative for TTF1, CDX2, 5100, HMB45, CD99, Melan A, CD45. Ki 67 index >90%.

Male 53 years

Excision of left clavicular lesion ?dermatofibroma.

Male 64 years

Excision of compound naevus right jawline. 5100 diffusely positive, EMA positive cells present at the periphery.

Female 90 years

Pyogenic granuloma right ala.

Male 59 years

Amelanotic melanoma right thigh.

Male 77 years

Excision SCC vertex of the scalp. Positive for CD10 and SMA, negative for AE1/3, S100, Melan A, p40, desmin, caldesmon, CD34 and CD31.