Hands and Feet Annular

 Annular lesions on the hand particularly the dorsum include a ringworm or Tinea Manum 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.(cornoid 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,

 

I-Infective   Tinea (Ringworm),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,

 

P-Physical   Cupping,ECG suction caps,

 

M-Metabolic   Reticular erythematous mucinosis

 

E-Endocrine

 

N-Nutritional

 

Others -           Annular erythema of infancy,

 

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