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August 18, 2008

Red Annular Plaque on the Dorsum of the Foot—Quiz Case

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Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Dermatol. 2008;144(8):1051-1056. doi:10.1001/archderm.144.8.1051-d

A 46-year-old man presented with a 1-year history of a lesion on the dorsum of his right foot. He had been treated with several topical antifungal agents, with no improvement. His medical history was unremarkable. Physical examination revealed a brownish, annular, alopecic, anesthetic plaque measuring 5 cm in diameter, with an erythematous, well-defined raised margin (Figure 1). No other areas of the skin were affected. There was no peripheral nerve enlargement. Two biopsy specimens were obtained from the border of the lesion and sent for routine hematoxylin-eosin (Figure 2 and Figure 3), Ziehl-Nielsen, and periodic acid–Schiff staining; bacterial, mycobacterial, and fungal cultures were also performed.