Ringworm Look-Alikes

Ringworm Look-Alikes
Q:
Ringworm Look-Alikes

My son, Jerimie, is seven years old. Ever since he was two he has developed a skin condition that looks similar to ringworm. We have taken him to the doctor for a diagnosis and they have diagnosed him with ringworm. We treated the area with Lotrimin and the condition did not go away. The area is not red, simply raised bumpy skin in a circular form. It has not spread to anyone else. With time (2-3 months) the condition simply disappeared. At times it comes back in the same area for a month or two. The area does not itch or bother my son at all. I was simply curious as to what it might be.
Kyra McBrayer – Oklahoma City, Oklahoma

A:

Dr. Greene`s Answer:

When ringworm is treated with an appropriate antifungal medication, such as Lotrimin, improvement is usually seen within 7 to 10 days. Treat it for at least one week following the clearing of the rash to make sure that all of the fungus is gone.

Ringworm, tinea corporis on an infant's leg

If the condition does not go away with 4 weeks of treatment, then it was probably not ringworm in the first place.

Many other skin conditions look similar enough to ringworm for the diagnosis to be commonly confused.

Granuloma annulare is a common skin condition with raised, flesh-colored bumps that appear in a ring. It may occur on any part of the body (though most commonly on the sides or backs of the hands or feet). The bumps may be red at the beginning, but this disappears as the ring forms. There is no itching or scaling. The rings vary in size from about 1/4 inch to 2 inches in diameter.

No one knows for certain what causes granuloma annulare. It is not an infection. I believe it is probably a slow hypersensitivity reaction that some individuals develop to different types of minor trauma. It may, however, be related somehow to diabetes. Most children with granuloma annulare are healthy and don’t go on to develop diabetes, but diabetes does occur more commonly in people who form these rings than in those who don’t.

Granuloma annulare usually disappears spontaneously within several months of appearing (though it can take years). In almost half of cases the ring comes back for a while, usually at the original site. Sometimes localized lesions may respond to topical steroid ointments. Some physicians recommend treating this condition with steroid injections, or even stronger medications. Since the ring is usually not bothersome, and usually disappears on its own, I do not routinely recommend treatment. Often these rings will disappear following a small injection of sterile saline, so if treatment is chosen, I would consider this simple, safe method.

Nummular eczema is another common skin condition that is often mistaken for ringworm. This is a coin-shaped patch of dry, scaly skin. Itching is variable. Nummular eczema is aggravated by bathing, soaps, and irritants such as wool. Treatment involves limited bathing, generous use of alcohol-free moisturizers, and topical steroid creams. This can keep the patch under control, but it is not unusual for the condition to flare up again at the original site.

Occasionally patches of nummular eczema disappear when someone is taking an antibiotic for some other reason. Bacteria can invade the skin in these dry, scaly areas. If a patch of nummular eczema is stubborn, try treating with an antibiotic ointment.

Other conditions that occasionally look like ringworm include seborrhea, psoriasis, pityriasis, contact dermatitis (such as poison oak), drug reactions, tinea versicolor, vitiligo, erythema migrans (a rash seen in Lyme disease), and even lupus. Your physician can differentiate these from ringworm by a skin scraping or biopsy, if necessary.

Your question, Kyra, touches on an issue of profound importance. The take-home lesson is that a “feedback loop” is a critical part of your relationship with a doctor. When a doctor looks at a raised ring on the skin (or any condition), it is appropriate to make the most likely diagnosis based on the available information (and any testing that might be indicated). If things don’t improve as expected, make sure to tell your doctor, so that this new information can be used in setting a course from here.

This living cycle of observation and reevaluation allows the most accurate insight into the mysterious workings of Jerimie’s unique body. Whatever issues arise with his health, let your experience with this ring remind you to keep the loop connected.

Do you need more information on ringworm look-alikes? Let us know below.

Reviewed by: Khanh-Van Le-Bucklin, Rebecca Hicks
Last reviewed: April 06, 2009
Dr. Alan Greene

Article written by

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

 

Comments

  • fragilesongbird

    my 7 month old has had a ring rash on her chin for over 6 weeks off and on now. I originally treated it with lotramin and it disappeared in about a week. Then it returned with a vengeance. I decided to try something I had been prescribed that I knew was a prescription anti-fungal nystatin triamcinolone acetonide ointment. Which helped immediately, within 24 hours it looked clear. But I continued to treat the area for 2 weeks to be sure it was gone. After 2 weeks I stopped and she seemed to be rid of it. Then the other day I noticed tiny bumps in that area and I couldn’t find the nystatin so I put the lotramin back on it, and it has just grown into the big pink spot again, it’s at the stage before the distinct ring with white center. Right now it looks like a big pinkish red jagged edged circle on her chin. She is teething so her chin stays wet which I know helps it. But, I don’t know what else to do. I have sprayed tinactin anti-fungal spray all over her stuffed toys and bedding then washed them in hot water and wiped down anything she has chewed on with bleach. I thought I had cleaned enough that it wouldn’t return. Why is she continuing to get this?? I know the nystatin triamcinolone acetonide has a steroid in that probably helped it look better but that is why I treated it for 2 weeks even after it appeared to be gone. She hasn’t spread it to anyone or herself. It is only this one spot on her chin. Please help!!

  • tamara tyler

    My son in the past two weeks, has a circular thing on his wrist. It began right after football started. So at first we thought it was ringworm..maybe got it from shared football pads. It was one now it has developed into several smaller circles. no pain, no fever. He is healthy. I have treated with antibiotic cream, cleaned it with alcohol. I just can’t figure out what it could be? I’ll try to send a picture. thanks!

  • Candy Lutz Rosenbaum

    I would love opinions on my photos below. For about 2 years, I have been back to the dermatologist. He took a scraping and just told me it’s not cancer.. not sure if he looked for anything else. He is quite sure it is either eczema or psoriasis. I asked him about ringworm but he said “no that’s not it” in his confident “I know more than you” voice so I didn’t bring it up again… I have tried several topical prescriptions for both eczema and psoriasis under his care. But the spots are only getting larger and spreading. right now the problem spots are all on my legs below the knee, though the first one I had was on my arm and it eventually went away (sun exposure?) Now that they are getting bigger they are starting to itch more (especially when covered) looking at photos of ringworm, it really looks like what I have. I don’t want to argue with my doctor, but whatever he is prescribing is not working and I am miserable. Please look at the photo and tell me what you think. I am thinking to try treatment at home for ringworm and see what happens. At this point, what could it hurt?

    • MartiaR

      try using using mometasone furoate cream, .1% and ketoconazole 2%, i mixed them together and wow it killed the them with the first application, I used it from head to toe, works great, it doesnt stop the spreading but it quickly kills what you can see.

    • karen sheean

      Hi Candy,

      Did you ever find out what your rash was? I have the same rash! Sow of them have dryness in the middle…

      Thanks,
      Karen

      • Candy Lutz Rosenbaum

        Hi Karen,
        I think mine is psoriasis. it was getting really bad so I went back to the doctor. he suggested I go on an oral medication Methotrexate, that sounded pretty scary.. I would have to have my liver checked every week. yikes! I told him I didn’t want to start it until after the holidays. So, in the meantime he prescribed Halabetasol Proprionate (aka Ultravate) ointment.. which is a steroid… Well, after 2 weeks, the rash was gone. All that’s left now is some patchy coloring similar to odd tan lines. He now has me on a vitamin D ointment to prevent it from coming back. I still have had a couple spots pop up on my arms and back of my thigh, but if I put the ointment on them early, they go away in a matter of days. Hopefully I can wear shorts this summer! I hope you figure out what yours is.

  • Dolly

    My 7 months old baby has ringworm like red circular raised at the edges and plane in the middle patch on his cheek. This developed when he was 2 months old and went when he was 5 and half. But now again its coming on the same area of the cheek. It seems its now coming on one of his leg too. Can you tell me what it can be.

  • Tracy Spencer

    I had a quartersize red circle appear on my back leg then small ones on legs then another bid one on other leg and thigh and small one one belly what is this

  • brashrash

    Hi. My wife first noticed a rash on her left hip that looked like ringworm, but it wouldn’t go away. Soon, it started to spread to her buttocks and all down the back of her legs. There is a little irritation on her back and arms, but it is mostly her legs and buttocks. She went to a dermatologist and was initially told she might have Lupus. However, after a biopsy, it was determined that she didn’t have Lupus after all. She was prescribed Prednisone and given some topical steroids. Neither seemed to make much of an impact on her condition and she had been back to the dermatologist twice before being sent to an allergist. Ringworm was ruled out and nobody seems to know exactly what she has or how to treat it effectively. Her latest prescription is Levocetirizine.
    There is cause for concern because this rash has lasted for nearly 5 months. Does anyone have any advice that could help? We’re not really sure where to go from here. Thanks.

    • Ve

      I have the same thing it went away for a few days after a steroid and benadryl shot , but now its back. I’ve had it for three months. Ive went to the doctor and they keep given me cremes and prednisone. They are in all the places you described and my armpits.

  • NewGal_InTheCity

    Hi I have developed a red scaly round patch of dry skin which when touched seems very dry. It started off as a small spot, developed a ring shape later on with middle part normal and then turned on to be a single patch. I thoght it was ringworm but didnot treat it as I am not medically insured. Its been left for two months untreated and I am now afraid its psorosis as it has not spread to family members or my husband. Also I have developed some red very dry small circular patches on my torso, which i thought was just dry damaged skin caused due to the extreme winter conditions (I live in canada). Also none of my skin conditions have been itchy, rarely once maybe i felt an itch but i when i put cream on it it disappeared. Can you tell me whether its psorosis or not, i hope is not because its a chronic ailment

  • American Citizen

    In Santa Fe NM, In march 2010 I stepped on a piece of cactus that our dog had brought in. Shortly after I got this skin condition that itched like crazy, it was a very painful itch. For several months I tried everything I could think of, anti-biotic creams, and things we had for the horses, various oils, Aloe Vera, you name it I tried it. I think stress was also a factor. I went to the ER the pain for so bad, and they told me it wasn’t ringworm because of the small satellite ring nearby. but they gave me a steroid which helped, but didn’t cure it. Then a friend who’s a botanist gave a a product she makes called trementina , this worked, but now it’s come back with a vengeance, its been 4 years now and I am scared. There are many nights I cannot sleep because of the intense itching. Please help. I can send you pictures.