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Annular skin lesions

Authoring team

morphology

scale, hyperkeratosis or crust usually present

non-scaling*

Typically annular lesions

common/fairly common causes

  • ringworm (scaling particularly at margin)
  • porkeratosis (keratotic border)
  • pityriasis rosea - herald patch
  • granuloma annulare
  • Jessner's lymphocytic infiltrate
  • morphoea (not annular lesions but often has annular violaceous margin)

less common causes

  • erythema annulare centrifugum
  • subacute cutaneous lupus erythematosus
  • pigmented purpuric dermatoses (fine scale only)
  • linear IgA disease, chronic bullous dermatosis of childhood
  • actinic granuloma
  • eczema surround a naevus (Meyerson's naevus)
  • purpura annularis telangiectodes
  • serum sickness and serum sickness-like drug eruption
  • erythema (chronicum) migrans
  • 'annular erythemas' with deeply situated infiltrate

Often includes some annular or incompletely annular (arciform) lesions

common/fairly common causes

  • psoriasis
  • bullous pemphigoid
  • seborrhoeic dermatitis of the trunk
  • subacute cutaneous lupus erythematosus (papulosquamous/psoriasiform type)
  • impetigo
  • urticaria
  • erythema multiforme
  • lichen planus (particularly male genital) *

less common causes

  • mycosis fungoides
  • atopic dermatitis **
  • cutaneous sarcoidosis*
  • B-cell lymphoma of skin

* some typically non-scaling disorders may occur as less common variants with scale

** atopic dermatitis is common, but discoid or annular lesions are relatively uncommon

Reference:

  • (1) Smith LC et al. A guide to annular eruptions. Dermatology in Practice (April 2008); 16(1).

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