What is the diagnosis for a recurring annual red circular rash with a cluster of vesicles (blisters) in the center?

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Differential Diagnosis for Red Circular Rash with Cluster of Blisters

  • Single most likely diagnosis
    • Herpes Zoster (Shingles): This condition is characterized by a red, circular rash that can appear annually, especially in individuals with weakened immune systems. The presence of a cluster of blisters in the middle is a hallmark of shingles, which is caused by the reactivation of the varicella-zoster virus.
  • Other Likely diagnoses
    • Eczema (Dyshidrotic): This condition can cause red, circular rashes with blisters, although the annual recurrence and specific pattern described might be less typical.
    • Contact Dermatitis: An allergic reaction to certain substances can lead to a red, circular rash, potentially with blisters, but the pattern and annual recurrence might not fully align.
    • Tinea (Ringworm): A fungal infection that can cause circular rashes, but these typically do not have a cluster of blisters in the center and might not recur annually in the same location.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lyme Disease: Although the rash (erythema migrans) is typically singular and expands over time, in rare cases, it could be mistaken for other conditions. Given the potential severity of untreated Lyme disease, it's crucial to consider it, especially if the patient has been exposed to ticks.
    • Erythema Multiforme: A skin condition that can be triggered by infections or medications, characterized by target-like lesions, which might not exactly match the description but can be severe and should not be overlooked.
  • Rare diagnoses
    • Granuloma Annulare: A rare skin condition that can cause circular rashes but typically does not present with a cluster of blisters.
    • Erythema Annulare Centrifugum: A condition that causes annular (ring-shaped) eruptions, which might fit the description but is relatively rare and would require further investigation to diagnose accurately.

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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