Flexures Annular

Annular lesions in the flexures

Annular lesions in the flexures 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),and sometimes the inverse type of Pityriasis rosea which may be limited to the groin.

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, Petaloid seborrhoeic eczema,Genital lichen planus,Herald patch of Pityriasis rosea,

 

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

 

G-Granulomatous    Granuloma annulare,Sarcoidosis,Elastolytic granuloma

 

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,Jesner's lymphocytic infiltrate,Erythema multiforme

 

P-Physical   Cupping,ECG suction caps,Pigmented purpuric dermatosis

 

M-Metabolic   Reticular erythematous mucinosis

 

E-Endocrine

 

N-Nutritional

 

Others -           Annular erythema of infancy,Erythema annulare centrifugum

 

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