This site is intended for health professionals only


Granuloma annulare vs tinea corporis

The latest in GP and hospital practitioner Dr Andy Jordan's series on differentiating two often similar-looking skin conditions

Both granuloma annulare and tinea corporis conditions may have a circular appearance with a raised edge, but their aetiology and treatment are very different.

Granuloma annulare

• Usually occurs before middle age

• Twice as common in women as in men

• Presents as a papule which gradually expands to form a ring of red or flesh-coloured papules, like cobblestones – you can stretch the skin to see this better

• No scale – due to dermal pathology

• Tends to enlarge centrifugally

• May be solitary or multiple

• Can appear anywhere, but usually on back of hands, feet, ankles or the overlying bony promontories of fingers

• Painless, but may be itchy – especially during the expanding phase

• Possible – but unusual – association with diabetes, so it's worth testing urine

• Tends to remit spontaneously, but if itchy topical steroids may be used sparingly

• Intralesional steroids and cryotherapy are effective for localised lesions.

Tinea corporis

• Can occur at any age

• Is an infection of hair-free skin caused by any of the dermatophytes

• Equal incidence in both sexes

• Very characteristic lesions – usually circular with a raised erythematous active, scaly edge

• Lesions may be single or multiple

• Often central resolution of inflammation, but there may be post-inflammatory pigmentation in the centre of the lesion

• Size of the lesion gradually increases

• Lesions may be anywhere on the body

• Pustules may be present in the lesion if the dermatophyte is of animal origin

• Infection may have arisen in the web spaces of the toes, so check the feet

• Runs a chronic indolent course without treatment

• Topical imidazole or topical terbinafine may be all that is needed, but oral terbinafine might be necessary

• If topical steroids have been used inappropriately on the lesion, then the scale may not be evident (tinea incognito)

• Have a low threshold for taking skin scrapings.

Dr Andy Jordan is a GP and hospital practitioner in dermatology in Chesham, Buckinghamshire

Tinea corporis Tinea corporis Granuloma annulare Granuloma annulare


          

Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.