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November 1989

Annular Vesiculation

Author Affiliations

USA; Headquarters, US Army Medical Department, APO New York, NY

Arch Dermatol. 1989;125(11):1569-1570. doi:10.1001/archderm.1989.01670230111022

REPORT OF A CASE  A 20-year-old woman presented with a 1-week history of three enlarging annular vesiculobullous lesions of the right forearm. The lesions began as small vesicles on an erythematous base and slowly enlarged to form two small bullous lesions and a larger bullous annular lesion with some central regression (Fig 1). The patient complained of localized pruritus and mild tenderness but was otherwise healthy and was receiving no medications.A physical examination revealed three vesiculobullous lesions with clear exudate and some crusting. The lesions ranged in size from 1 cm to 5 cm, with the largest lesion showing a vesicular border and some central regression.A Tzanck preparation (Fig 2), cultures, and a skin biopsy (Fig 3) were done.What is your diagnosis?

DIAGNOSIS:  Bullous tinea corporis caused by Trichophyton rubrum.

CLINICAL COURSE  The Tzanck preparation revealed hyphal elements intermixed with clumped

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