Ringworm Look-Alikes

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

Question

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

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.

 

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 (ringworm look-alikes) for the diagnosis to be commonly confused.

Ringworm Look-Alikes: Granuloma

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) and is most often localized to one area. 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 and is not contagious. 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 and thyroid disease. Most children with granuloma annulare are healthy and don’t go on to develop diabetes or thyroid problems, but these do occur more commonly in people who form these rings than in those who don’t, especially if the rash is widespread.

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. When lesions are widespread, some physicians recommend treating this condition with steroid injections, freezing treatments (cryotherapy), UV light therapy or even stronger medications. All of these treatments may have side effects, so a thorough discussion with your doctor is needed before pursuing any form of treatment. 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.

Ringworm Look-Alikes: Nummular Eczema

Nummular eczema is another common skin condition that is often mistaken for ringworm. The word nummular comes from the Latin word “coin,” and this rash is named so because it is a coin-shaped patch of dry, scaly skin. Itching is variable, and some people also describe a burning-like sensation. Common triggers for development of nummular eczema include medications, dry or damaged skin, bug bites, , and contact with metals like nickel. 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.

Ringworm Look-Alikes: A Host of Less Common Culprits

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.

References and Resources

Piette EW, et al. “Granuloma annulare: Pathogenesis, disease associations and triggers, and therapeutic options.” J Am Acad Dermatol 2016;75:467-9.

Last medical review on: August 15, 2020
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Deb,

This is indeed interesting. Have you found any additional information? If not, it’s likely time to go for a physical exam.

Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

Look up Pityriasis Rosea! My son has the same thing! It is wild. No rhyme or reason. He had his first outbreak in pre-k he is now 7 and having his second. They dont know much about it, however cortisone cream and sun light has helped. Not contagious and takes forever to go away!

A ring itchy not dry or scaly size of a quarter formed four months ago first time ever and I’m forty years old it went away on my neck and came back on bottom of my neck now size of a baseball

Good morning! My husband has had dozens of small, red, raised rings on his outer thighs and buttocks appear in just two days. He says that they do not itch. I initially thought that he has Ringworm but there are so many of them and they are all 1/2″ or smaller. I have always associated Ringworm with a single large ring… Could this be Ringworm or possibly something else? As a retired Biology teacher, I’ve already spent hours researching his symptoms and cannot find a satisfactory diagnosis. Please advise at your earliest convenience and thank you in advance for your time.

Deb,

This is indeed interesting. Have you found any additional information? If not, it’s likely time to go for a physical exam.

Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

Hello Precious,

I’m so sorry you are going through this — particularly the lack of feeling. It is important that you see a doctor for an accurate diagnosis before treatment can begin.

Sincerely, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I have it just on my back nowhere else rings that PCP says is ringworm I’ve used all the creams and such that the doctor gave me and it’s still there so I tried home remedies on my back it burns when applied and the itching goes away for a few hours then comes back wtf do I do ?

Good day sir….I’m a female and I’m 24 years old….I have a skin discoloration all over my body.i noticed it on my lap and arm when I was a kid and it kept spreading over the years…The ones on my face has blended together while other parts are still spreading….I dont feel sensation on affected parts especially my foot and hands…I dont feel pains when I’m injured and i don’t feel it when I’m touched on my toes…please help me.

Hello Precious,

I’m so sorry you are going through this — particularly the lack of feeling. It is important that you see a doctor for an accurate diagnosis before treatment can begin.

Sincerely, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

Evelyn,

I hear your concern. I can’t answer that over the internet. I think it would be smart to ask your doctor at an in-person visit so she can look at the skin and possibly take a sample of the skin to send to the lab.

Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

After having my second child I have had consistent stomach bloating problems, constipation ongoing, skin sores with string like things (poking out at he edges of the sore, that can actually retract), when wearing skin masks, squiggly trails disperse from the sores & area directly surrounding, I’ve never seen or experienced anything like this before. I get blurred vision when these sores wheep & they do seem to want to spread, when doing so tiny individual strings branch out, turning into many before forming another sore ( i can see this because, being irritated by the movement, obtained an enlarging mirror to get a better look & was almost fascinated by what I saw, multiple times over. On some parts of my face & neck I have what appears to look like white pigment spots, however over time or in heat I assume, they blister slightly to reveal one of those stringy things. I’m always lethargic now, I feel like a freak at times & previous to this I ran my own company, basically alway high achiever with modelling background, very healthy until this. I’ve had every skin condition under the sun relayed to me of what the doctors think, yet in five years thousands of dollars, embarrassment etc etc nothing has resolved my problem- however I purchased ivermectin on line & this seems to clear up most symptoms, most definitely 90% better than doctors have prescribed. And now I’ve been placed in the “too hard” basket, because gps etc don’t want to deal with it at all. So it leaves me in exactly the same position.
Can someone help me please,
Yours sincerely

I have a rash all over my body which kind of resembles ringworm it is on my feet legs thighs arms his and torso but not my face it is itchy embarrassed when I put lotion on it can anyone tell me what this may be?