What is the diagnosis for a patient with a scattered annular (ring-shaped) macula with central clearing, suggestive of annular macular dystrophy?

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Differential Diagnosis for Scattered Annular Macula with Central Clearing

  • Single most likely diagnosis
    • Erythema migrans (Lyme disease): This is the most common diagnosis for a scattered annular macula with central clearing, particularly if the patient has a history of tick exposure. The rash is often accompanied by other symptoms such as fever, headache, and fatigue.
  • Other Likely diagnoses
    • Tinea corporis (ringworm): A fungal infection that can cause annular lesions with central clearing, often itchy and can be found on various parts of the body.
    • Granuloma annulare: A benign skin condition characterized by a ring of small, bumps or lesions, often with central clearing, typically found on the hands and feet.
    • Nummular dermatitis: A type of eczema that can cause coin-shaped patches of dry, itchy skin, sometimes with central clearing.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Erythema multiforme: A skin condition that can cause target-shaped lesions, sometimes with central clearing, and can be a sign of a life-threatening condition if not promptly treated.
    • Rocky Mountain spotted fever: A bacterial infection that can cause a rash with central clearing, often accompanied by fever, headache, and other severe symptoms.
  • Rare diagnoses
    • Secondary syphilis: A stage of syphilis that can cause a variety of skin rashes, including annular lesions with central clearing.
    • Leprosy: A chronic bacterial infection that can cause skin lesions, including annular ones with central clearing, often accompanied by nerve damage and other symptoms.
    • Sarcoidosis: A condition that can cause granulomatous lesions, including annular ones with central clearing, often affecting the lungs, skin, and other organs.

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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