Lesions are oval-shaped, scaly, skin- to salmon-colored papules or plaques. Topical, intralesional, or oral corticosteroidsĬan begin with a herald patch, followed by a diffuse eruption involving the trunk and proximal extremities. Favors the dorsal aspects of the extremities. Non-scaly, erythematous to violaceus colored papules or plaques with a thin, smooth border. Often associated with a scaly, palpable edge. Summary of Diseases, Clinical Features, and TreatmentĪsymmetric, well-demarcated, erythematous lesion with or without central clearing. ( See Table 1.) This review also may be helpful especially in cases of suspected tinea that are refractory to treatment. Key morphological characteristics of annular lesions can improve diagnostic accuracy, leading to correct initial treatment. While tinea may be readily identifiable, a wide variety of clinical entities mimic these infections, leading to confusion and, often, misdiagnosis. In adults, the most common etiology of annular lesions is tinea, a superficial fungal infection of keratinized tissue. In contrast, the term nummular, derived from the Latin word “nummulus,” meaning coin shaped, is used to describe sharply marginated, round to disc-shaped lesions without central clearing. 1 These lesions have a characteristic appearance, described as round to oval-shaped patches or plaques with central clearing. The term annular is derived from the Latin word “annulus,” meaning ring shaped. Among the common presentations seen on a day-to-day basis are annular lesions. Sometimes the rash is new onset, and sometimes it has been present for a while and refractory to treatment. Stephan Stapczynski, MD, Editor IntroductionĪlthough rashes are not usually an emergency, it is common for emergency physicians to see patients come in with a rash. This article interested me because it broadened my awareness about this type of rash. With round rashes, my differential was limited to tinea, if it had been there for a while, or urticaria and erythema multiforme, if it had just started. Like you, I’ve had little training in dermatology most of what I know was learned on the job and through continuing education. In erythema multiforme, the characteristic target lesions remain fixed for multiple days, as opposed to the transient lesions of urticaria.Nummular eczema is common during the winter months, with crusting, hyperpigmented, coin-shaped plaques on the lower legs, dorsal hands, and extensor surface of the arms.Psoriasis is suggested when lesions occur on the extensor surfaces of the limbs, umbilical region, and sacrum.As a general rule, the individual lesions last less than 24 hours. Urticaria produces wheals and well-defined, erythematous superficial swelling of the dermis.Pityriasis rosea produces diffuse eruption on the trunk and proximal extremities with oval-shaped, scaly plaques.Localized granuloma annulare produces annular lesions with smooth, non-scaly contours.Tinea corporis produces well-demarcated, erythematous, dry, and scaly lesions with raised red borders and central clearing.Annular skin lesions are round with central clearing, whereas nummular lesions are round with discrete margins without central clearing.
0 kommentar(er)
