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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
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Experience:  30 years practice in general and cosmetic dermatology
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I occassionally get a perfect circle ring on my face at my

Resolved Question:

I occassionally get a perfect circle ring on my face at my temple. It comes back at the same spot each time and is the same size. It is red around the very edge. The rest of the inside is normal color. It does not spread or get larger and I have never had it appear anywhere else. Can this be related to any Thyroid conditions. A nodule has been found on my thyroid.
Submitted: 2 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 2 years ago.

dermdoc19 :

Good afternoon.

dermdoc19 :

I have a few ideas, but a photograph would be very valuable. Which anti-fungal cream did you use? Does it go away completely when it goes away? Any symptoms? Does it have any scale in the red area?

Customer:

It goes away completely. The last time that I had it was a year ago or more. The cream I used was a clotrimazole cream USP,1% from Walgreens (over the counter). I used it in case it was ringworm. My concern is, if it is ringworm, why does it keep coming back at the same place and does not spread or get larger. Is that normal for ringworm? Would it go away on its own? I thought ringworm was highly contagious. I cannot see scale on the red ring.The ring is very red and very thin around the edge. It looks like someone branded me with a hot iron that is circular. The edge is a little raised and slightly sore to touch - like a burn. The inside looks normal. The circle around the edge is fairly defined and and is very symmetrical. I have tried to find something that looks like it on the computer but all of them have more ragged edges and are not a well-defined circle. It is the size of a M&M. I do not know how to get a picture to you.

dermdoc19 :

I can think of a few lesions that would fit this. However, the face is an unusual location for them. The lesions that I can think of include: Granuloma Annulare, Erythema Annulare Centrifugum, Porokeratosis of Mibelli and of course, Tinea Facei (ringworm of the face).

dermdoc19 :

Ringworm is not necessarily that contagious but it certainly should have some scale to it. Erythema Annulare Centrifugum is quite consistent with your history in that it does come and go. That also usually has some scale to it. Most cases I have seen involve the thighs or lower legs..a few on the flanks. This would also be an unusual site for Granuloma Annulare. Porokeratosis of Mibelli can affect the face. I would suggest looking at some of these entities and get back to me for treatment suggestions. As I mentioned, the diagnosis is very difficult in lesions like this without a photograph, so if you can find someone with some expertise that could send me one that would be very helpful.

dermdoc19 :

In the meantime: I would go ahead and treat this as ringworm. Try an antifungal from a different drug group than Clotrimazole. You might try Lamisil cream which is an Allylamine. ( Clortrimazole is an azole and attacks the fungus differently than the allylamine group). Be sure to use it for two weeks AFTER the rash seems have cleared. Also use Stiefel anti-fungal soap on your face. Doing all this, should eliminate this cause.

dermdoc19 :

Granuloma Annulare and erythema annulare centrifugum are both associated with thyroid disease. Erythema Annulare Centrifugum is known to be associkated with both hyperthyrooidism and hypo-thyroidism and Grave's Disease. Usually thyroid disease is associated with generalized granuloma annulare in which there are ring-like lesions, usually quite small, all over the body, not limited to the face as in your case.

dermdoc19 :

By the way, during this time did a dermatologist have the opportunity to examine your rash and if so what did he/she think?

dermdoc19 :

Happy to answer further questions or make clarifications.

Customer:

http://www.dermis.net/dermisroot/en/41100/diagnose.htm I could not get a picture taken but I did find that the first picture at this site, I found on the internet, looked most like it. It was a porokertosis mibelli web site. I have not seen a dermatilogist since it has gone away in the past. I am concerned because it keeps coming back and, each time, looks the same and in the same place.

Customer:

Please see last post.

dermdoc19 :

You might ask your physician to try either Efudex cream or Vectical. They are both prescription items and have been successfully used for Porokeratosis of Mibelli.

dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 3996
Experience: 30 years practice in general and cosmetic dermatology
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