What causes a diffuse rash characterized by circular erythematous lesions with central clearing and pruritus?

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Differential Diagnosis for Diffuse Rash with Circular Erythematous Lesions and Central Clearing with Pruritus

  • Single most likely diagnosis
    • Tinea corporis (ringworm): This is a common fungal infection that causes circular, erythematous lesions with central clearing and pruritus, making it the most likely diagnosis.
  • Other Likely diagnoses
    • Eczema (atopic dermatitis): Can present with diffuse rash and pruritus, although the lesions may not always have central clearing.
    • Contact dermatitis: An allergic reaction to substances like plants, metals, or chemicals, which can cause a rash with similar characteristics.
    • Pityriasis rosea: A skin condition that starts with a single patch (herald patch) followed by a diffuse rash with circular lesions and central clearing.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lyme disease: Although less common, Lyme disease can cause a distinctive rash (erythema migrans) that is circular with central clearing, and missing this diagnosis can lead to serious complications.
    • Rocky Mountain spotted fever: A tick-borne illness that can cause a rash, although it is typically more petechial and less likely to have central clearing.
  • Rare diagnoses
    • Erythema migrans-like lesions in southern tick-associated rash illness (STARI): A rare condition caused by the bite of the lone star tick, which can mimic the rash of Lyme disease.
    • Granuloma annulare: A rare skin condition that can cause circular lesions with central clearing, although it is typically less pruritic and more localized.

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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