Not every annular rash is tinea: Recognising erythema annulare centrifugum

CASE
A girl of Asian descent aged 12 years, who was accompanied by a parent, presented with a 1-week history of a pink-red ring-shaped lesion on her left forehead (Figure 1A). She had been using topical Hydrozole (1% hydrocortisone and 1% clotrimazole) obtained elsewhere, with limited effect. On examination, a solitary erythematous annular lesion with mild scaling and central sparing was observed. A week later, the lesion had slightly increased in diameter while retaining its central clearing (Figure 1B). The patient reported mild pruritus but no systemic symptoms. There were no other cutaneous lesions and no personal or family history of skin disorders. She was not on any regular medications.