What is the diagnosis for a patient presenting with an annular rash characterized by distinct borders and a scaly center, suggestive of ringworm (tinea)?

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Differential Diagnosis for Annular Rash with Distinct Borders and Scaly Center

  • Single most likely diagnosis
    • Tinea corporis (ringworm): This is the most common cause of an annular rash with distinct borders and a scaly center. It's a fungal infection that can affect any part of the body, characterized by a circular, itchy, and scaly lesion.
  • Other Likely diagnoses
    • Nummular dermatitis: This condition presents with coin-shaped lesions that can have a scaly center and distinct borders. It's often seen in individuals with a history of atopic dermatitis or dry skin.
    • Granuloma annulare: A benign skin condition characterized by a ring-shaped lesion with a scaly center, often found on the hands and feet.
    • Lichen planus: An inflammatory condition that can cause annular lesions with a scaly center, typically seen on the skin and mucous membranes.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lyme disease (erythema migrans): Although less common, Lyme disease can present with an annular rash (erythema migrans) that has distinct borders and a scaly center. Early diagnosis and treatment are crucial to prevent long-term complications.
    • Cutaneous T-cell lymphoma (mycosis fungoides): A rare type of skin cancer that can cause annular lesions with a scaly center. It's essential to consider this diagnosis to ensure timely treatment and prevent disease progression.
  • Rare diagnoses
    • Sarcoidosis: A systemic disease that can cause skin lesions, including annular rashes with scaly centers. It's a rare condition, but considering it in the differential diagnosis can help identify patients who require further evaluation.
    • Erythema annulare centrifugum: A rare skin condition characterized by annular lesions with a scaly center, often associated with underlying infections, inflammatory diseases, or malignancies.

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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