Discoid Lupus Erythematosus Lesions of Intermediate

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At this stage, central atrophy becomes apparent, and active sectors of the lesion appear as annular or semicircular peripheral erythemas (Fig. 11.1C). DLE lesions of the scalp usually belong to this category (see below).

Superficial dermatophytic infections typically present as nummular lesions with raised erythematous, scaly borders and central clearing. Annular and semicircular lesions are often found. In contrast to DLE, there is no atrophy. In adults, superficial mycoses are mainly found in the context of tinea pedis and in the inguinal folds and only exceptionally on the trunk or face. Children are much more prone to develop superficial mycoses of the face, but they only rarely develop DLE. Potassium hydroxide examination of scales will quickly reveal the etiology.

Erythema arcuatum, the superficial variant of granuloma annulare, is characterized by stable, erythematous, slightly infiltrated annular lesions predominantly of the upper trunk. In contrast to DLE, the lesions are quite large, the erythematous rings display no scaling, and the centers are nonatrophic.

Erythema annulare centrifugum lesions may be somewhat reminiscent of DLE but they are predominantly located at the trunk and do not exhibit central atrophy, and their elevated borders typically show collerette-like scaling that is nonadherent and localized to the interior slope of the margin. Also, erythema annulare is not stable but is characterized by slow migration.

Superficial basal cell carcinoma may occasionally somewhat resemble DLE. It is usually located on the trunk, may display an atrophic center, and is reddish owing to the presence of telangiectasias. In contrast to DLE lesions, it is not too well defined and has a raised border of translucent peripheral papules (which may be not very conspicuous). Scaling, if present, is scant.

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How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

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