Annular Scaly Plaques
Am Fam Physician. 2016 May 15;93(10):865-866.
A 57-year-old woman presented with a largely asymptomatic rash on her feet that began six months earlier. She had infrequent mild pruritus but no other symptoms related to the rash. She had no systemic symptoms such as fever, chills, myalgias, or arthralgias. The rash did not improve after two months of treatment with terbinafine cream (Lamisil).
Physical examination demonstrated well-circumscribed, erythematous, annular plaques on the dorsa of her feet that were 3 to 4 cm in diameter (Figure 1). The plaques had no induration, but there was a trailing white scale. They were nontender to palpation, and the surrounding skin was unaffected. Findings from a potassium hydroxide preparation of the scale were negative.
Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?
A. Erythema annulare centrifugum.
B. Granuloma annulare.
D. Tinea pedis.
REFERENCESshow all references
1. Bolognia J, Jorizzo J, Schaffer JV, Callen JP, eds. Dermatology. 3rd ed. Philadelphia, Pa.: Elsevier Saunders; 2012....
2. Marks JG, Miller JJ, eds. Lookingbill and Marks' Principles of Dermatology. 5th ed. Philadelphia, Pa.: Elsevier Sanders; 2013.
3. Ziemer M, Eisendle K, Zelger B. New concepts on erythema annulare centrifugum: a clinical reaction pattern that does not represent a specific clinicopathological entity. Br J Dermatol. 2009;160(1):119–126.
4. Lebwohl M, ed. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. London, UK: Mosby; 2002.
5. Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. St. Louis, Mo.: Elsevier; 2016.
6. Mease PJ, Gladman DD, Papp KA, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69(5):729–735.
This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.
A collection of Photo Quiz published in AFP is available at http://www.aafp.org/afp/photoquiz.
Previously published Photo Quizzes are now featured in a mobile app. Get more information at http://www.aafp.org/afp/apps.
The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at http://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. E-mail submissions to firstname.lastname@example.org.
Copyright © 2016 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions