Systemic lupus erythematosus (SLE) is the most common type. This is a single round or oval-shaped lesion that is 2 to 10 centimeters (cm) in diameter. How to tell if i have ringworm or lupus rash? Healthline Media does not provide medical advice, diagnosis, or treatment. Both eczema and ringworm tend to inflame and redden the skin and can make it dry, swollen, crusty, and itchy. The differential diagnosis of urticaria: Part I. Grattan CE, Saini SS. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Not All Round Rashes Are Ringworm: A Differential Diagnosis of Annular and Nummular Lesions. SLE is the most common type of lupus. Moriarty B, Hay R, Morris-Jones R. The diagnosis and management of tinea. Lupus can also lead to pulmonary hypertension, a form of high blood pressure in which the blood vessel connecting the heart to the lungs thickens. Vasoconstriction means that the blood vessels constrict and limit the blood supply to the fingers, says Stojan. It causes rough, scaly skin to develop on the face and scalp. (https://jamanetwork.com/journals/jamadermatology/fullarticle/1818978). (See Figure 2.) Use these professionally produced online infographics, posters, and videos to help others find and prevent skin cancer. Can lupus cause rashes and itchiness on other parts of the body besides the face? What does a lupus rash look like on darker skin? This can signal subacute cutaneous lupus. Its thought that the rashes occur because of exposure to sunlight, says George Stojan, MD,an assistant professor of medicine in the division of rheumatology at the Johns Hopkins University Medical School and the codirector of the Hopkins Lupus Center in Baltimore. Doesn't itch or cause pain. Fungal Diseases. Approximately two out of every three people withlupus will develop some type of skin disease, known as cutaneous lupus erythematosus, according to the Lupus Foundation of America. Feldmeier H, Schuster A. Mini review: Hookworm-related cutaneous larva migrans. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Chronic discoid lupus rashes or sores may put you at risk for skin cancer. Flaky, visibly greasy, white to yellow scaling overlies affected areas.36 Most cases are pruritic, and symptoms generally intensify with sweat.32,36, Seborrheic dermatitis may closely resemble tinea or psoriasis, especially in the groin. There can also be hair loss when lesions are on the scalp, and in some cases the hair grows back as before, but not always, according to Werth. Diagnosis is based on clinical findings and supported by a recent history of potential exposure. They feel extremely tired. Dr. Miller reports he is on the speakers bureau for Abbvie and Allergan. Doctors typically provide answers within 24 hours. One of the first symptoms of lupus nephritis is edema, or swelling due to fluid buildup in the legs, ankles, and feet. (2014, March 21). In lupus, the immune system can damage healthy red blood cells. Tinea corporis is associated with a fine scale and commonly affects the trunk, unlike NE, which has a thick crust and occurs almost exclusively on the extremities. Even during a global pandemic, lupus researchers have made strides in understanding this rheumatic disease, who is at highest risk, and what treatments Shannon Hester was diagnosed with lupus nearly 20 years ago. J Am Acad Dermatol 2016;75:1081-99. It appears by the malar area of the cheeks around your cheekbones "and it has the shape of a butterfly as it goes across the bridge of the nose, says Dr. Werth. Some rashes can scar. The trusted source for healthcare information and CONTINUING EDUCATION. During a first-time flare, this rash can resemble ringworm. If left alone, one half of cases will resolve within two years.8 If treatment is preferred, high-potency topical corticosteroids or intralesional triamcinolone can be used.8,9 Although most cases heal without residual skin findings, recurrence is common regardless of treatment.9, Pityriasis rosea is a common eruption primarily seen in adolescents and young adults.10 The etiology remains unknown, but given its seasonal variation, occurring mostly in the spring and fall, a viral cause is suspected.11 The eruption is aptly named pityriasis, meaning scaly, and rosea, meaning pink. Heres what you need to know. Difficulty arises when patients present asymptomatically after an eruption, limiting the exam. Brendan Camp, MD, FAAD Find out what can help. By using our website, you consent to our use of cookies. Wood GS, Reizner GT. In people with white skin the patches appear pink, and on people with darker skin the patches can look darker, he says. As with most tick bites, an erythematous, small, round papule will appear at the site of the bite, and within days, the surrounding erythema will migrate peripherally, forming a large, erythematous plaque.17 The expanding border will be warm and slightly raised without an associated scale, while centrally, a ring may clear, resulting in an annular or pathognomonic bulls-eye appearance.18,19 (See Figure 3.) In: Bolognia JL, Schaffer JV, Cerroni L. James WD, Berger TG, Elston DM. Some people develop a nail infection, which can cause splitting or crumbling nails and discoloration (A), or swollen skin and discoloration around the nails (B). In discoid lupus, the lesions can sometimes form scars, and hair will not grow back because the hair follicles are also scarred, she says. Free to everyone, these materials teach young people about common skin conditions, which can prevent misunderstanding and bullying. Damage, such as scarring, hair loss, and lighter and darker skin, could be permanent in cases of discoid lupus. Steroid creams and other treatments help. You don't currently have a subscription to allow access to this publication. This autoimmune disease may impact your skin, nails, and hair. Wieczorek IT, Propert KJ, Okawa J, et al. Lesions have a predilection for the trunk and proximal extremities, sparing the hands, feet, face, and mucosa.14 When pressed, lesions should blanch. Centrally, lesions may be hyperpigmented or skin-colored.24 LP may mimic tinea, granuloma annulare, or porokeratosis of Mibelli (discussed later). Connective Tissue Diseases. In: Bolognia JL, Schaffer JV, Cerroni L. Ramos-e-Silva M, Ribeiro de Castro MC. Its also called chronic cutaneous lupus. Acute cutaneous lupus lesions or rashes happen when systemic lupus is active, according to the Lupus Foundation of America. Discoid sores on your lips or inside of your mouth may develop a type of skin cancer called squamous cell carcinoma. ENT. When lupus affects the nails, it can cause: If you have discoid lupus and a darker skin tone, you may develop dark, blue-black nails. Okon LG, Werth VP. This means the disease is active, causing symptoms. The rash typically isnt itchy or painful and rarely leaves scars. Shiohara T, Mizukawa Y. Lichen planus and lichenoid dermatoses. Researchers are still learning why, but treatments are similar across. Sometimes, visible blood vessels appear around the nails. Peroni A, Colato C, Schena D, Girolomoni G. Urticarial lesions: If not urticaria, what else? Read More Created for people with ongoing healthcare needs but benefits everyone. J Am Acad Dermatol 2010;62:667-71. Slightly raised, expanding rings. 2013 Jun;27(3):391-404. limiting in that humans are dead-end hosts. Small, violaceous, polygonal-shaped papules and plaques with a diffuse network of white streaking. Lupus is an inflammatory disease that causes a rash to form on the body and, in an initial form, can resemble a ringworm rash. They'll look for signs of a fungal infection. A butterfly rash (malar rash) on the face affects many people with lupus, but lupus rashes can appear anywhere on your body. or getting flushed in the face? You may see a rash, sores, swelling, or other changes. When seborrheic dermatitis is present on the face, lesions are remarkably symmetric, mostly affecting the forehead, eyebrows, and retroauricular areas.36 When present in large folds, seborrheic dermatitis tends to be centered along the crease, whereas tinea is less often as symmetric.36 In addition, patches and plaques of seborrheic dermatitis typically are more numerous and appear greasier than lesions of tinea. This butterfly rash is a sign of acute cutaneous lupus (ACLE). Some lesions might look like ringworm with rough, red patches. Should people with lupus stop taking medications before getting their shots? The most common signs and symptoms include: Fatigue. Weston G, Payette M. Update of lichen planus and its clinical variants. In: Bolognia JL, Schaffer JV, Cerroni L. James WD, Berger TG, Elston DM. UV exposure brings on or worsens skin problems for as many as 7 in 10 people with lupus. The skin is red and scaly. Notoriously, these infections are caused by dermatophytes, a collective term that describes three genera Microsporum, Trichophyton, and Epidermophyton. It produces a coin-shaped red, scaly rash on the cheeks, nose, and ears. 2018;18(3):e411-e412. Many isolated tracts may be present, each representing the course of an individual larva. Clinically, NE follows a chronic course characterized by well-demarcated, erythematous, or hyperpigmented coin-shaped plaques with diffuse crust.37 (See Figure 9.) lupus? Lupus rash and skin changes often accompany other symptoms of lupus, which can include fatigue, pain and swelling in the joints, and swollen glands. This article interested me because it broadened my awareness about this type of rash. Cutaneous lupus erythematosus: diagnosis and treatment. Best Pract Res Clin Rheumatol. Nummular eczema should be differentiated from tinea corporis and psoriasis. This type of reaction indicates that your skin is photosensitive. Retrieved from, What causes hemolytic anemia? EM is self-limiting and usually resolves within weeks without complications.14 For limited cutaneous disease, symptomatic treatment with oral antihistamines or low-potency topical corticosteroids is sufficient.43 In recurrent cases precipitated by herpes simplex virus eruptions, chronic suppressive antiviral therapy with valacyclovir is effective.14 When oral lesions are present, topical corticosteroid gels and swish and spit rinses containing a mixture of lidocaine, diphenhydramine, and kaolin are helpful.14 In severely ill patients, systemic corticosteroids should be considered.43, Hansens disease, also known as leprosy, is a rare, chronic granulomatous disease caused by Mycobacterium leprae.44 Although mostly a disease of the developing world, cases in the United States occur in those who have resided in foreign countries or those living in southeastern states with exposure to armadillos, a natural host.1,45 In almost all new cases, a history of close contact with an untreated, infected individual is obtainable.45 Once a patient is infected, the disease has an insidious onset and an incubation period that ranges from three to 20 years.1 Hansens disease primarily presents in two forms, tuberculoid leprosy and lepromatous leprosy.45 In both forms, cooler areas of the body such as the skin, peripheral nerves, upper respiratory tract, and eyes are affected.1,45 Warmer areas such as the axilla, groin, and scalp usually are spared. Avoiding UV light exposure can lessen your chances of developing a lupus skin rash. In: James WD, Berger TG, Elston DM. Discoid lupus, a type of cutaneous lupus, causes circular red rashes on your body. What steps can I take to prevent a future lupus rash? Widespread disease is treated with oral albendazole or invermectin.27, Porokeratosis of Mibelli is a rare, genetically inherited disorder of epidermal keratinization that arises during childhood or adolescence.29 Lesions begin as small, skin- to brown-colored papules that enlarge over the course of years, forming plaques with raised, ridge-like borders and atrophic, hyper- or hypopigmented centers.30 (See Figure 7.) Everyone's at risk for skin cancer. If you already have a subscription to this publication, please. Therefore, eruptions occur in regions in which sebaceous glands are most active, such as the scalp, face, eyebrows, ears, and presternal area (see Figure 10), as well as large body folds such as the axillae and groin.36 Lesions are more common in men and are characterized by gradual onset of sharply demarcated patches or thin plaques that vary in color from red to orange to yellow. . Topical or intralesional corticosteroids; oral corticosteroids if severe. (Be sure to follow your state laws). Sometimes, a rash or other sign of lupus causes a symptom like itch or pain. It's not contagious and usually not painful, but it can make you feel self-conscious. Annular, skin- to brown-colored plaque with a raised, ridge-like border. Erythema and Urticaria. Well-demarcated, erythematous or hyperpigmented scaly or crusty coin-shaped plaques. These tiny vessels can be dilated or broken near the surface of the skin and appear as fine pink or red lines. Reviewed by: With proper treatment for lupus, this lost hair often grows back. caseating epithelioid granulomas.7 In newly diagnosed cases, a chest X-ray is warranted and, if abnormal, patients should be referred for pulmonary evaluation.9, Treating the underlying systemic disease often clears cutaneous lesions.9 Limited cutaneous eruptions can be treated with intralesional triamcinolone.9 Systemic corticosteroids are effective but generally are reserved for active pulmonary, ocular, cardiac, and central nervous system involvement or when skin disease is widespread.9, Seborrheic dermatitis is a common, chronic dermatosis present in up to 5% of the population.32 The pathogenesis has been linked to the overproduction of sebum and Malassezia yeasts. Protozoa and Worms. Though it. The Best and Worst Diets for Heart Health, Type 2 Diabetes Drug Mounjaro Leads to 16 Percent Weight Loss in New Trial for Treatment of Overweight or Obesity. After it resolves, it can leave white patches or discolored patches or possibly scarring, he says. Treatment consists of imidazoles, mainly ketoconazole, as a shampoo when present on the scalp or cream when present on the face and body.36 Topical steroids work quickly and are effective but should be limited because of the risk of steroid rosacea.32 Once cleared, daily maintenance therapy is important to prevent relapse. Acutely, lesions may ooze and have associated vesicles.38 Most will lack central clearing, although in some cases, plaques can expand and clear centrally, conferring an annular appearance.1 Lesions are especially common during winter months when skin is dry and primarily present on the lower legs, dorsal hands, and extensor surface of the arms.39 Excoriations often are prominent because of intense pruritus.36. Annular skin lesions are round with central clearing, whereas nummular lesions are round with discrete margins without central clearing. James WD, Berger TG, Elston DM. Having SCLE can make you more sensitive to the sun, so you need to be careful when going outside or sitting under fluorescent lights. Although characteristic plaques predominate, variations in morphology are not uncommon. It is not difficult to tell the difference. You can expect permanent results in all but one area. For information on new subscriptions, product Differential diagnosis of annular lesions. For most patients, ECM at the site of the tick bite is the first sign of infection.17 However, only about half of patients presenting with ECM will recall a recent bite or exposure to ticks. Sometimes the rash is new onset, and sometimes it has been present for a while and refractory to treatment. Lupus doesnt cause blisters, says Stojan. Chronic urticaria almost always occurs in adults and often does not have an obvious trigger.20 The eruption is composed of wheals, well-defined superficial swellings of the dermis that are characterized by raised, erythematous papules or plaques surrounded by a red flare.21 (See Figure 4.) Signs and symptoms of ringworm may include: A scaly ring-shaped area, typically on the buttocks, trunk, arms and legs. 2023 Healthline Media LLC. my face gets red daily & occasionally extra redness in shape of butterfly rashes. Primary lesions can reach 15 cm in diameter and commonly are found on the trunk, axilla, groin, and popliteal fossa.17,18 Days to weeks following the primary eruption, a subset of patients will develop secondary lesions that are smaller and less pronounced than the primary lesion. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Consider one of the subscription options below to receive full access to this article and many more. Hansens Disease. Within days, erythematous papules followed by characteristic thin, red, torturous tracts begin to appear.26 (See Figure 6.) When lupus affects the skin, swelling can be one of the first signs of lupus. EAC often has a waxing and waning course that persists for about nine months.1,14 Most cases will subside spontaneously without treatment, leaving no residual scar.