What are the causes of macular lesions with scaling?

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Last updated: May 8, 2025View editorial policy

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Differential Diagnosis for Macular Lesions with Scaling

  • Single most likely diagnosis
    • Pityriasis rosea: This condition is characterized by the appearance of macular lesions with scaling, often starting with a herald patch. The lesions typically follow a Christmas tree distribution on the trunk and proximal extremities, making it a common and likely diagnosis for macular lesions with scaling.
  • Other Likely diagnoses
    • Tinea corporis (ringworm): A fungal infection of the skin that can cause macular lesions with scaling, usually in a circular pattern.
    • Seborrheic dermatitis: A chronic inflammatory skin condition that can cause macular lesions with scaling, particularly on the scalp, face, and torso.
    • Psoriasis: An autoimmune condition that can cause macular lesions with scaling, often on the elbows, knees, and scalp.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Secondary syphilis: A sexually transmitted infection that can cause macular lesions with scaling, often accompanied by other systemic symptoms. Missing this diagnosis could lead to serious complications if left untreated.
    • Lymphoma-associated skin lesions: Certain types of lymphoma can cause skin lesions that may appear as macular lesions with scaling. Early detection is crucial for effective treatment.
  • Rare diagnoses
    • Pityriasis lichenoides: A rare skin condition characterized by the appearance of macular lesions with scaling, often accompanied by other systemic symptoms.
    • Keratosis follicularis (Darier's disease): A rare genetic disorder that can cause macular lesions with scaling, particularly on the torso and extremities.
    • Mycosis fungoides: A rare type of cutaneous T-cell lymphoma that can cause macular lesions with scaling, often accompanied by other systemic symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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