What are the distinguishing features between nummular dermatitis and tinea infections?

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Differential Diagnosis for Annular Eczema and Tinea

Single Most Likely Diagnosis

  • Tinea corporis (ringworm): This is the most likely diagnosis due to the characteristic annular (ring-shaped) lesions with a clear center, which is a hallmark of tinea infections. The lesions are often itchy and can be accompanied by redness and scaling.

Other Likely Diagnoses

  • Annular eczema (nummular eczema): This condition presents with coin-shaped lesions that can be itchy and inflamed, often occurring after skin injury or irritation. The lesions can resemble those of tinea corporis but tend to be more irregular in shape.
  • Granuloma annulare: A benign skin condition characterized by ring-shaped lesions composed of small bumps, often on the hands or feet. It is usually asymptomatic and can be mistaken for tinea corporis or annular eczema.
  • Pityriasis rosea: An acute skin condition that starts with a single "herald patch" followed by a widespread rash of smaller, oval-shaped lesions, often in a Christmas tree distribution. While not typically annular, the initial herald patch can be mistaken for tinea or eczema.

Do Not Miss Diagnoses

  • Lyme disease (erythema migrans): The initial stage of Lyme disease can present with an expanding, annular rash that resembles tinea corporis. Missing this diagnosis can lead to serious complications if left untreated.
  • Erythema multiforme: A skin condition characterized by target-shaped lesions, which can sometimes appear annular. It can be a sign of an underlying infection or autoimmune condition and requires prompt attention.
  • Cutaneous lymphoma (e.g., mycosis fungoides): A rare type of skin cancer that can present with various skin lesions, including annular ones. Early diagnosis is crucial for effective treatment.

Rare Diagnoses

  • Subacute cutaneous lupus erythematosus: A subtype of lupus that can present with annular lesions, among other skin manifestations. It is less common than other forms of lupus and requires specific diagnostic criteria.
  • Sarcoidosis: A systemic disease that can cause skin lesions, including annular ones, although this is a rare presentation. Diagnosis often involves biopsy and systemic evaluation.

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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