Photo Quiz

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.

Figure 1.


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.

C. Psoriasis.

D. Tinea pedis.

Address correspondence to Elizabeth Seiverling, MD, at Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.


show all references

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This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.

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