Arms and Legs Annular

Annular lesions on the Arms and Legs  include a ringworm or Tinea corporis infection,(scale and spreading),Granuloma annulare(no scale and dermal papules),Urticaria(itchy and last less than 24 hours),Erythema annulare centrifugum(trailing edge scale),Erythema chronicum migrans(spread following tick bite reaction),Erythema multiforme(target like lesions) and rarely Porokeratosis of Mibelli.(coronoid lamella)

Management- Take a history,Look at it carefully for scale and scrape if any.

SIGN DIP MEN Overview of Annular lesions

 

S-Squamous   Resolving psoriasis,Discoid eczema,Lichen simplex chronicus, Genital lichen planus,Herald patch of Pityriasis rosea, Pityriasis rotunda, Seborrhoeic dermatitis

 

I-Infective   Tinea (Ringworm),Erythema chronicum migrans,Leprosy,Syphilis,Erythema marginatum,

 

G-Granulomatous    Granuloma annulare,Sarcoidosis,Elastolytic granuloma, Necrobiosis lipoidica , 

 

N-Neoplastic    Basal cell skin cancer,Mycosis fungoides,follicular mucinosis,Erythema gyratum repens,Necrolytic migratory erythema,Porokeratosis of Mibelli

 

D-Drugs  Reactive annular erythema after Vit K injections,can also occur after heparin,collagen steroid and anticancer agent injections,

 

I-Immunological     Urticaria,Angioedema,Subacute lupus erythematosus,Neonatal lupus erythematosus, Chronic bullous disease childhood - linear IgA

 

P-Physical   Cupping,ECG suction caps,

 

M-Metabolic   Reticular erythematous mucinosis

 

E-Endocrine    Autoimmune progesterone dermatitis

 

N-Nutritional

 

Others -           Annular erythema of infancy, Elastosis perforans serpiginosa , Pigmented purpura of Majocchi  Rarely eosinophilic cellulitis  Eosinophilic pustular folliculitis of Ofuji

 

Annular red brown lesions with scale and central scar  Tertiary syphilis,lupus vulgaris,lupus erythematosus,sarcoidosis,cicatricial pemphigoid,leishmaniasis(purplish scar in recidivans)